Canadian Journal of Nursing Research最新文献

Background: Since legalization of Medical Assistance in Dying in Canada in 2016, nurses are increasingly faced with new and evolving communication challenges as patients in a diversity of settings and contexts contemplate their end-of-life options.

Purpose: The purposes of this study were: 1) to develop an understanding of the nuances and challenges associated with MAID-related communication from the perspective of registered nurses, and 2) to draw on the insights arising from this analysis to reflect on the evolution of MAID communication for nurses over time.

Methods: This study represented a secondary analysis of two primary qualitative data sets, including: 74 interviews of Canadian registered nurses self-identifying as having some exposure to MAID in their clinical practice; and 47 narrative reflections volunteered by respondents to questions posed in an online MAID reflective guide for nurses.

Results: Nurses described evolving complexities associated with introducing and engaging with the topic of MAID with their patients, helping patients navigate access to MAID assessment, managing family and community dynamics associated with opinions and beliefs surrounding MAID, supporting patients in their planning toward a MAID death, and being there for patients and their families in the moment of MAID.

Conclusions: MAID communication is highly complex, individualized, and context-specific. It is apparent that many nurses have developed an impressive degree of comfort and skill around navigating its nuances within a rapidly evolving legislative context. It is also apparent that dedicated basic and continuing MAID communication education will warranted for registered nurses in all health care settings.

Background: In Canada, the healthcare experiences and needs of Muslim women who wear Islamic head coverings are conflated with the larger Muslim community who do not wear Islamic head coverings. Understanding their specific and unique preferences and challenges is essential for tailoring care and improving healthcare encounters.

Purpose: The study purpose is to explore the healthcare encounters of Muslim women wearing Islamic head coverings in Canada, focusing on how discourse influences their narratives.

Methods: A postructuralist narrative methodology was used to understand how power, knowledge, language, and discourse impacted their experiences. Semi-structured interviews were conducted with eight Muslim women. Narrative analysis was used to dissect stories and the way these stories were told.

Results: Five themes were identified, including: The Fingerprint: Highlights the importance of recognizing individual identities to provide personalized care.The Membrane: Examines how societal biases and assumptions permeate healthcare professionals and impacts care.The Heartbeat: Reveals the immediate emotional and physical responses that reflect systemic challenges within healthcare encounters.Unseen: Emphasizes the lack of acknowledgement experienced by Muslim women related to their healthcare preferences and/or needs.Heard: Encompasses instances where Muslim women feel recognized by their healthcare provider; contrasts Theme #4.

Conclusion: This research emphasizes the diverse experiences of Muslim woman who wear an Islamic head covering and the need for healthcare professionals to move away from a one-size-fits-all approach and instead, provide care that respects the unique preferences amongst this diverse group.

Background: Population aging is a global phenomenon. Many older adults living with chronic conditions rely on family and friend caregivers. The growing demand for family and friend caregivers underscores the necessity for adequate and effective support services.

Purpose: The Saskatchewan Caregiver Experience Study sought to gather the perspectives of caregivers of older adults and set priorities for caregiver support.

Methods: An online survey with open-ended questions was employed in this qualitative descriptive study. In this manuscript, we present our findings from the survey question: "What do you think is most important for support in your caregiving role? In other words, what are your top priorities for support?"

Findings: This survey question received n = 352 responses, evenly distributed across Saskatchewan in urban-large (33%), urban-small/medium (32%), and rural (35%) settings. Support priorities of Saskatchewan caregivers were found to be access to help when they need it; an ear to listen and a shoulder to lean on; assistance in optimizing the care recipient's health; having healthcare professionals that care; and improved policies, legislations, and regulations.

Conclusion: Services and interventions that assist caregivers are more likely to be accessed and utilized when caregivers are given the opportunity to identify their own support priorities. This study has the potential to inform health and governmental systems to support caregivers of older adults provincially within Saskatchewan, nationally in Canada, and in a global context.

Study background: Reducing children's vulnerability to climate change (CC) depends firstly on parents having the ability to adapt.

Purpose: The purpose of this study was to describe knowledge, attitudes, and perceptions of nurses in support of parents' ability to adapt to CC to protect the physical and psychosocial health of 0-5 year olds.

Methods: A cross-sectional descriptive study was used. A total of 127 pediatric nurses from the province of Quebec completed an online questionnaire documenting nurses' knowledge, attitudes, and perceptions about CC.

Results: A third of nurses have little or no knowledge of the health risks of CC for children, even though they consider it to be a major issue for children. Nurses perceive that parents don't generally consider their children to be among the most vulnerable to CC, trivialize their effects on their children's health, have little knowledge of the effects of CC mainly on their children's psychosocial health, know little about the means to use to protect them, and more readily seek help from family and friends to ensure their children's protection. Nurses affirm that they are responsible for discussing the health effects of CC with parents, introduce measures to reduce their effects, possess little knowledge and few skills for reducing their effects, and feel unprepared to deal with their effects in their practice.

Conclusions: Greater access to training on CC-related concepts is needed to increase nurses' knowledge. Nurses' perceptions must be validated with parents to promote optimal protection of children from CC.

Impostor syndrome is a common phenomenon experienced by individuals when entering new ranks in the workplace. Although women experience greater feelings of imposter syndrome than men, Black individuals report a prolonged experience of imposter syndrome when compared to their white counterparts, which negatively impacts their everyday experiences, health, and overall well-being. With growing studies showing the pervasive nature of anti-Black racism on the health of Black people, there remains a paucity of studies showing the connection between anti-Black racism and imposter syndrome. Within nursing, anti-Black racism can be seen to foster imposter syndrome through discriminatory practices that affect the career development, recruitment, and retention of Black nurses. Anti-Black racism is prevalent, and, in this paper, two Black nurses share insight through their own encounters with imposter syndrome and its relationship with anti-Black racism. Guided by Black feminist thought, they use art to navigate their reflective discourse as a means of reclaiming their identity and positionality as leaders in their rights. Reflective discourse is ideal for transformative learning to occur through dialogue. In addition, it promotes the use of art for deeper discussions when understanding the Black experience. Together, these nurses explicate how adopting Afrocentric knowledge and practices through their reflective discourse can affirm their identity, promote a sense of belonging, and assist in dismantling the effects of anti-Black racism and imposter syndrome within nursing.

Background and purpose: Despite documented accounts of racial discrimination against Chinese communities during the COVID-19 pandemic, few studies have examined experiences of racism among Canadian youth. This qualitative study explored the experiences of Chinese-Canadian youth during the COVID-19 pandemic and their mental health.

Methods: A qualitative descriptive research design, informed by Critical Race Theory (CRT), was used for this study. Data was collected using focus groups and image-based elicitation methods. Youth who self-identified as Chinese-Canadian, aged 18-24, and who experienced some account of self-defined racism were included. We analyzed the data using a coding system developed for this study and formulated key themes.

Results: Our analysis identified three themes: (I) Becoming racialized; (II) Learning the rules of racism; and (III) Effects of racism on mental health. We discuss findings in relation to the model minority stereotype, intersectionality of race and gender, and factors leading to a lack of support.

Conclusions: This study provides evidence that racism had immediate and prolonged effects on the mental health of Chinese-Canadian youth and their relationships with peers, family, and even strangers. Our research suggests the need for enhanced services for Chinese-Canadian youth and other groups experiencing racism.

Purpose: Obtaining meaningful clinical experiences with paediatric and perinatal (young families) populations is increasingly challenging for nursing programs. Care for this population has largely moved to outpatient and tertiary settings. Therefore, a current trend is to use non-traditional clinical settings. While summer camps offer rich learning experiences for nursing students, they are seldom used as clinical placements. Faculty at an Atlantic Canadian university sought a novel way to engage students in young families' learning by partnering with overnight summer camps, staffed by counsellors, camp administrators, and on-site nurses. Campers included those with lived experience of cancer, diabetes, physical and developmental challenges, and socioeconomic challenges. This study assesses how young families course outcomes were met by an innovative clinical experience within a Bachelor of Nursing program and describes the perceptions and experiences of those involved.

Methods: Study participants included students (n = 4), camp directors (n = 3), a camp nurse (n = 1), and the clinical educator (n = 1). Data collection involved semi-structured interviews and a focus group. Interpretive description methodology was used to identify themes and patterns related to overarching research questions.

Findings: Students met the outcomes and overall participant perceptions and experiences were positive. However, some participants shared constructive critiques for future consideration.

Conclusions: Nursing students who completed a young families clinical placement at summer camps met course outcomes, and those involved reported both positive experiences and constructive critiques for future consideration.

The COVID pandemic brought to light the pressing issues of social isolation and loneliness for older adults. Immigrant older adults' experience of loneliness is even more exacerbated by factors, such as, language barriers, and the loss of cultural community. Key determinants of loneliness in older immigrants are not clear in the literature. A cross-sectional study was conducted in nine cities across Canada to: describe the experience of emotional, social and overall loneliness; and examine the determinants of loneliness among Punjabi, Mandarin, and Arabic-speaking older immigrants. A total of 647 older immigrants participated in the study. Descriptive statistics were used to describe their experience of loneliness, and multiple regression analysis was performed to examine the determinants of loneliness. Most participants had a post-secondary education, were married, and had been in Canada for about 16 years. On average, the participants reported good physical and mental health, and moderate levels of emotional, social, and overall loneliness. Ethnocultural group, emotional wellbeing, and depression were associated with emotional loneliness. Social loneliness was associated with education, depression, psychological distress, age, and ethnocultural group. Determinants of overall loneliness were age, gender, ethnocultural group, self-rated mental health, emotional wellbeing, depression, and psychological distress. Community based interventions that target these key factors must be designed to address loneliness experienced by older immigrants.

Study background: The experience of discrimination through stereotyping, profiling, and bias-informed care not only leads to poor access to healthcare services, but low retention rates of Indigenous health professionals (IHP). As health systems transformation evolves, a significant gap remains in supporting IHP to safely address racism, to be supported culturally to bring their authentic selves and voices to work, and to attend to one's own intellectual, physical, relational, cultural and spiritual wellness within a westernized model of care.

Purpose: The aim of the study was to investigate the experiences of IHP working in mainstream healthcare in order to understand how their work environment impacts the delivery of cultural safe practices. What is reported in this manuscript, as an exercise in truth-telling, is findings about lived experiences of IHP working in one mainstream provincial healthcare region, and not the whole context and outcomes of the study.

Methods: Using Indigenous research methodologies, we embodied our Indigeneity into every facet of the research process. We facilitated three talking circles with participants grounded in a distinct cultural and ceremonial context following Secwepemc protocols.

Results: The collective voices of IHP revealed the following common experiences: confronting genocide; addressing Indigenous-specific racism; uprooting toxicity and inequities; and upholding Indigenous human rights while enhancing accountability of systems transformation.

Conclusions: The experience of IHP working in health systems goes beyond mere individual employment obligations, its often about a families and communities advocacy for Indigenous rights, culturally safe working environments and access to dignified and respectful healthcare service. This study highlights the need for IHP to be actively involved in health system transformation to ensure the redesigning and restructuring of healthcare service delivery by and for Indigenous Peoples remains centered on Indigenous health and human rights.

Background: Intimate partner violence (IPV) is a wicked social problem affecting women of all social strata and geographical location, globally. Pregnancy may be a time of heightened risk of IPV and more deleterious outcomes. Breastfeeding - a protective factor for maternal and child well-being - may be jeopardized or more challenging for women experiencing IPV. This study explored the experiences of postpartum women with histories of IPV who sought trauma- and violence-informed breastfeeding support from primary care providers.

Methods: Using interpretive description and philosophically underpinned by intersectionality, in-depth semi-structured interviews were completed at 12-weeks postpartum with five breastfeeding mothers with a history of IPV who sought breastfeeding support from a family physician clinic employing a trauma- and violence-informed (TVIC) model of care.

Findings: Four themes and two sub-themes shed light onto the experience of accessing breastfeeding support for women with a history of IPV and the perceived barriers that they faced when attempting to accesses this support, including: 1) The (demoralizing) navigation of the perinatal system; 2) Fostering trust: i) "It's support, but it's also knowledge"; and ii) TVIC: feeling safe and feeling "I mattered"; 3) Informal support: partners, family, and friends; and 4) Baby in focus: overcoming challenges and building confidence.

Conclusions: TVIC may aid in the development of trusting therapeutic relationships, in turn improving access to breastfeeding support, breastfeeding self-efficacy, and breastfeeding success for women who experience violence. Further research on the implementation and evaluation of TVIC for perinatal breastfeeding education and care among women is required.