Canadian Journal of Nursing Research最新文献

This paper introduces and discusses factor analysis techniques for construct validity, including some suggestions for reporting using the evidence to support the construct validity from exploratory and confirmatory factor analysis techniques. Construct validity is a vital part of psychological testing and a prerequisite to every measurement instrument, including aptitude, achievement, and interests. Research, particularly in nursing and the health sciences, depends on reliable and valid measurements. Therefore, a growing emphasis is on assessing validity regarding the structure of test variables commonly estimated by factor analysis techniques. However, it is not always clear how to report the analysis and use it to support the construct validity. Both exploratory and confirmatory factor analysis techniques provide vital evidence to support the construct validity. However, these are not the only available evidence for construct validity, and the researcher should always consider other sources of evidence to develop and support the construct validity of their intended measures. In addition, the collection and presentation of this evidence are not limited to a time, but the validity of constructs is a continuous process that leads to validating the underlying theories from which constructs have emerged.

Background/purpose: Racism and hidden bias experienced by underrepresented nursing students contribute to a loss of confidence and anxiety. The A-CHARM nursing project developed virtual simulation experiences for nursing students to practice how to address racism. 'Nik's Story' virtual simulation was created as part of the A-CHARM project. The purpose of this study was to examine the effectiveness of an education intervention, that included Nik's story, on cultural humility and cultural diversity awareness.

Method: This quasi-experimental study included a convenience sample of final year nursing students. After informed consent, participants completed a pre-intervention questionnaire that included the Cultural Humility Scale "context for difference in perspective" subscale, and the Cultural Diversity Awareness questionnaire to assess baseline knowledge. Students participated in an education intervention that included a lecture, Nik's story virtual simulation experience, a debrief and then completed a post-education/simulation questionnaire that included usability/learner engagement questions and the Cultural Humility Scale "context for difference in perspective" subscale, and the Cultural Diversity Awareness questionnaire.

Results: Forty-seven students consented and completed the pre/post intervention questionnaire. Participants rated the effectiveness, engagement and usability of the simulation experience highly. There was a significant positive change in cultural humility "context for difference in perspective" subscale (pre-scores = 6.9, SD = 3.3; post-scores = 31.0, SD = 3.8, p < 0.001), and cultural diversity awareness (pre-scores = 95.4, SD = 8.9; post-scores = 103.4, SD = 9.8, p < 0.001).

Discussion: This intervention was effective in improving cultural humility and cultural diversity awareness in nursing students.

Conclusion: Simulation experiences regarding racism in the clinical setting provide a strategy for students to learn how to professionally navigate unwanted experiences.

Background: The intersection of the COVID-19 pandemic with systemic anti-Black racism in the form of police violence and the subsequent Black Lives Matter movement has created an especially critical juncture to examine the mental health of Black youth.

Purpose: The purpose of this study was to understand the intersecting impacts of anti-Black racism and the COVID-19 pandemic on the mental health of Black youth.

Methods: A youth-engaged research approach and intersectionality framework were utilized. Semi-structured interviews with Black youth across Canada (ages 16 to 30, n  = 48) were conducted online via Zoom and analyzed using thematic analysis. Fourteen Black youth were hired to form a Black youth advisory committee, who guided the research process.

Results: The "dual pandemics" of the COVID-19 pandemic alongside highly publicized incidents of racism and the subsequent Black Lives Matter movement negatively impacted participants' mental health. Four main themes emerged: (1) ongoing exposure to acts of anti-Black racism (2) compounding effect of racism on mental health; (3) high stress levels and fear; and (4) anger and emotional fatigue from lack of shared, long-term solutions.

Conclusion: The simultaneous occurrence of the COVID-19 pandemic and instances of systemic anti-Black racism in the form of police violence presented "dual pandemics" for the Black community, profoundly impacting the mental health of Black youth and adding urgency and impetus to its prioritization. Results of this study indicate that it is critical to explore each event individually as well as the combined impact on the mental health of Black youth, particularly from a racial perspective.

Study background: The effects of systemic racism were exacerbated and amplified throughout the COVID-19 pandemic. The resurgence of the "Black Lives Matter" movement in North America brought awareness to the public, especially white people, of the impacts of systemic racism in society and the urgent need for large-scale and institutional anti-racism work.

Purpose: In collaboration with a local Community Health Centre, this research focused on identifying priority areas for tailored and co-developed anti-Black racism interventions in health services and community programming, as well as examining how purposeful relationships can be created with African, Caribbean, and Black (ACB) communities in London, Ontario.

Methods: Semi-structured interviews were conducted in either French or English with nine formal or informal leaders from London's ACB communities. Interpretive description methodology guided analysis and interpretation.

Results: Participants indicated that anti-Black racism is ever-present in the community and in their lives, with systemic racism causing the most harm. Racism should be addressed by creating ACB-specific services, and education for non-Black communities; increased representation, inclusion, and engagement of ACB people within organizations, especially in leadership roles, are essential. A framework based on study findings to guide how organizations can develop authentic and purposeful relationships with ACB communities is presented.

Conclusions: Organizations will continue to perpetuate systemic racism unless they actively seek to be anti-racist and implement strategies and policies to this end. The proposed framework can guide partnerships between health and community organizations and ACB communities, and support co-development of strategies to address anti-Black racism.

As a "foursome" of nursing history students and scholars, upcoming, junior, and seasoned, we presented a panel on new work and possibilities related to histories of Blackness and Black nurses in Canadian nursing history. Our presentation was the 2023 keynote Hannah Panel Presentation for the joint Canadian Society for the History of Medicine (CSHM-SCHM) and the Canadian Association for the History of Nursing (CAHN-ACHN) conference. Reflecting and expanding our perspectives, we share the relevance and significance of engaging with histories of Canadian Blackness and (in)visibility of Blackness in nursing history. This paper considers the overarching question of how does engaging with histories of Canadian Blackness serve as an anti-racist strategy when examining, analyzing and understanding the history of nursing and health care? A core tenant of this work aims at acknowledging how institutional relationships of power are reproduced within scholarship unless there is space for radical re-imaginations. The disruption to power is achieved by exploring the connections between nursing and history from the perspective of Black nurses' history or Black feminist thought. We also disrupt power by our form, in challenging expectations of scientific inquiry as the only format of valid knowledge production within the discipline. Possibilities of arts-based methodology as a site for democratization in nursing knowledge are evoked through the metaphoric language (water, fire, air and earth) interwoven within the text. We highlight how each of us engages with nursing history, further complicating previous narratives of our collective Canadian past. In publishing our thoughts on historical inquiry in a nursing journal, we hope to provoke more curiosity and interest in history within our discipline as a site for liberation!

Background: Stereotype about Black people contribute to nurses and healthcare providers gaslighting and dismissing of their health concerns. Despite the popularity of the term medical gaslighting in mainstream literature, few studies have explored the experiences of Black women during pregnancy and childbirth.

Purpose: This paper aims to provide an in-depth insight into Black women's experiences of anti-Black medical gaslighting when accessing care during pregnancy and childbirth.

Methods: Utilizing qualitative methods, we conducted 24 semi-structured interviews with Black women in the Greater Toronto Area. We used thematic analysis to ground the data analysis and to generate insight into Black women's experiences.

Results: Three overarching themes: 1) Not Being Understood: Privileging of Medical Knowledge Contributing to the Downplaying of Health Concerns, 2) Not Being Believed: Stereotypes Contributing to Dismissive Healthcare Encounters and 3) Listen to Us: Turning off the Cycle of Medical Gaslighting. These themes highlight ways anti-Black medical gaslighting manifests in Black women's healthcare encounters to create differential access to treatment and care.

Conclusions: Anti-Black medical gaslighting contributes to differential access to treatment and care. Improving equitable access to treatment and care must involve addressing structural and epistemic biases in healthcare and fostering a culture of listening to humanize the experience of illness.

Background: The Period of PURPLE Crying Program® (PURPLE) is a universal parent education program that is delivered by nurses and health care providers to all parents/caregivers of newborns in British Columbia (B.C.). The aim of the program is to reduce the incidence of Traumatic Head Injury -Child Maltreatment (THI-CM), a form of child physical abuse.

Objective: To determine if the PURPLE program had an impact on the rate of physical abuse hospitalizations for children less than or equal to 24 months of age in B.C. since implementation in 2009.

Methods: The analysis measured physical abuse hospitalization rates for the period January 1, 1999 to December 31, 2019 and excluded any cases of confirmed Traumatic Head Injury-Child Maltreatment. Data were divided into pre-implementation period January, 1999 to December, 2008, and post-implementation period January, 2009 to December, 2019. Data were obtained from the Discharge Abstract Database and B.C. THI-CM Surveillance System to capture information on infant child abuse. Poisson regression and ANCOVA was applied to model the change in rates pre and post program implementation.

Results: Physical abuse hospitalization rates decreased by 30% post-implementation period (95% CI: -14%, 57%, p  =  0.1561). The decreasing linear trend in the post-implementation period was significantly different than the increasing linear trend in the pre-implementation period (F_1,17  =  4.832, p  =  0.042).

Conclusions: Nurses' role in engaging parents in conversations about PURPLE messages over multiple timepoints within a structured universal program model resulted in a decrease in physical abuse hospitalization rates since the implementation of PURPLE.

Background: Individuals living with diabetes mellitus (DM) are at an increased risk for multiple serious health complications including diabetic foot disease (DFD). Daily, DFD contributes to increased morbidity, mortality, increased hospitalization, limb amputation, and reduced quality of life. Prevention of DFD is a foundational component of diabetes management.

Purpose: The purpose of this study was to explore how individuals manage the care required to protect their feet from DM related foot complications.

Methods: This qualitative descriptive study utilized semi structured interviews to explore the perspectives of 23 participants on preventing foot care complications associated with DM. All data were analyzed using reflexive thematic analysis.

Results: Participants were challenged to consistently make health choices that were congruent with recommended DM self-management for the prevention of DFD. In addition, participants intuited multiple mixed messages from healthcare providers and workplaces that appeared to diminish their individual responsibility to self-manage their DM. Findings were organized under two main themes: a) Ineffective coping: Distancing self from disease b) Vacillating responsibility: Multiple mixed messages.

Conclusions: Nurses are in a unique position to provide the education and support needed to assist individuals in carrying out the many recommended self-care strategies to reduce the risk of DFD. Contextually, nurses must encourage consistent messaging among health care providers and workplaces to prioritize the health needs of individuals living with diabetes and to support the challenging work these individuals must navigate every day. It will take a concerted effort to reinforce the message that diabetes care is a priority for everyone.

Background: Data integration refers to combining quantitative and qualitative data in mixed methods. It can be achieved through several integration procedures. The building integration procedure can be used for developing quantitative instruments by integrating data from the qualitative phase. There are limited examples of data integration using the building procedure in mixed methods and implementation science.

Purpose: The purpose of this article is to illustrate how the pathway building technique can be used to integrate data in mixed methods research through concurrent use of implementation science models and frameworks.

Methods: This two pathway building technique was developed based on a mixed methods implementation project of developing implementation strategies to promote compassionate nursing care of complex patients.

Results: The first pathway is the integration of qualitative data from the first phase of mixed methods study with implementation models and frameworks to create a quantitative instrument (i.e., a Q-sort survey) for the subsequent phase. The second pathway is the operationalization of the Q-sort survey results (i.e., implementation strategies) using an implementation science specification framework.

Conclusion: The pathway technique is valuable for mixed methods research and implementation science as it offers a theory-based innovative method to tackle integration challenge.

Background: Migraine is a neurobiological condition characterized by a constellation of unpredictable symptoms and is the second cause of disability worldwide. Migraine is prevalent among nurses. However, literature exploring nurses' experience of living with migraine is scarce which has important individual and systems implications for health and wellness and patient safety. Self-management is essential in chronic disease management as the patient engages in various strategies to be able to live with their condition.

Purpose: This study explored the experiences of living and working with migraine among female nurses in Ontario, with particular attention to their priorities and strategies for self-management.

Methods: Interpretive description methodology was employed to guide this study and informed a thematic analysis approach to examine the self-management experiences of nurses living with migraine.

Results: Nurses engaged in various self-management strategies including pharmacological and non-pharmacological strategies and highlighted the role of technology in migraine self-management. Participants described experiences of living with migraine as an invisible condition including feelings of not being understood, stigmatization, and the absence of formal support at the workplace.

Conclusion: The implications of these findings support the incorporation of a critical approach to relational engagement that is person-centred including nonjudgemental, strength-based care as a practice approach when caring for persons living with migraines and the need to include experiential learning in educational curriculums as a strategy to reduce stigma against migraines.