Canadian Journal of Nursing Research最新文献

Technology has been integrated into every aspect of life for interpersonal support and connections and social isolation has become a hotspot topic for health promotion in nursing among various populations, but little attention has been paid to immigrant older adults using technology to overcome social isolation. The purpose of this narrative review is to comprehend the role of technology use in the context of social isolation, including the predisposing factors, encountered by immigrant older adults to support their psychosocial wellbeing. By studying relevant peer-reviewed articles published in professional databases from 2013 to 2024, 26 articles met the criteria and were accessed for this narrative review, despite an unexpected participant selection preference of older Asian immigrants living in a North American context among these eligible papers. It is discovered that technology use has improved the mental health of socially-isolated immigrant older adults. However, the benefits of technology use for these individuals are constrained by cultural and linguistic differences as well as educational backgrounds. Therefore, technology adaptation should be promoted in this population through a collaborative partnership with healthcare practitioners, educators, researchers and policymakers. There should be further exploration of the interrelationships between technology use and psychosocial support and continuous striving for the most suitable approach for social isolation prevention among immigrant older adults.

Engaging undergraduate students in nursing research is of high significance for capacity building and advancement of the nursing profession especially with current global constraints to health research. Helping students understand the significance of research can position students towards success in leveraging research in their future careers. Currently, while research as a core nursing course is offered in some schools of nursing, it provides an introductory understanding of research methods and does not often contain a practical application component of what students are learning from a theoretical perspective. This editorial provides strategies on how nursing schools, universities, practice-site organizations, and external funding bodies can modify their existing practices to offer direct, application, research-based opportunities for undergraduate nursing students. Particularly, thinking about how assignments can be modified to instruct students about diverse types of publications and knowledge dissemination options can contribute to students feeling like their voice matters and this work has impact beyond a singular course. Offering students opportunities at the university level to receive research mentorship and learn about the conduct of research from inception to dissemination can equip students with the skills they need to lead research upon graduation on practice-related, first-hand issues they are witnessing as nurses. Research shadowing opportunities or involvement in research within organizations where students are practicing can demonstrate the connection between theory and real-world use of research and impact. Finally, advocating for increasing funding opportunities for undergraduate students from external funders can enhance the accessibility and quality of mentorship in research for such students.

BackgroundThe novel demands on hospital capacity arising from the COVID-19 pandemic revealed already-existing systemic weaknesses. Intensive care units experienced a sustained surge capacity and were forced to introduce modified standards of care and practices.PurposeIn this article we use punctuated entropy as a conceptual lens to reveal the impact of the COVID-19 pandemic on Ontario hospitals by drawing attention to the cumulative impact of repeated disaster events on their capacity to recover.MethodsThis qualitative instrumental case study took place at a Medical-Surgical Intensive Care Unit in a university-affiliated teaching community hospital in a large urban center in Ontario, Canada. Twelve healthcare professionals from the ICU participated in in-depth semi-structured interviews.ResultsIn-depth interviews with healthcare providers revealed an already-vulnerable system and the disproportionate impact of COVID-19 on the nursing workforce, compounding pre- burnout and compassion injury.ConclusionThe structure of intensive care and the dynamics of collaborative practices within ICUs are subject to continual reconfiguration, potentially leading to punctuated entropy - a permanent state of a lack of capacity to recover. Disaster recovery planning in healthcare services delivery should not be focussed simply on navigating the 'temporary' effects of a single event, but rather on how the event interacts with the already existing 'pathological' state of the healthcare system. In this way solutions to longitudinal systemic problems in ICU healthcare delivery can be anticipated and plans for mitigation can be put in place.

BackgroundNurses engage in continuing professional education (CPE) to remain current in their knowledge and competencies, and to learn in ways that help them navigate an increasingly complex healthcare system. Recent trends indicate that CPE has shifted away from nurses' education to be more directed toward organizational and regulatory needs, which impacts nurses' professional learning.PurposeThe purpose of this research was to understand the influences that shape nurses' CPE choices and professional learning pathways, and the ways in which nurses learn.MethodsThis was an exploratory case study of later career nurses in Nova Scotia, Canada, that analyzed data from semi-structured interviews, participant artifacts, and government and regulatory policy documents. Critical and post-structural feminist lenses were applied to the data analysis.ResultsThree themes encompassing the key influences on nurses' CPE choices and learning pathways were identified: sociocultural context, structural/systems context, and shifting knowledge forms. The findings suggest that educational discourse embedded in the broader regulatory, government, and employer policy worked to direct the participants into CPE for employment and regulatory requirements, shaping nursing knowledge that reflects organizational needs.ConclusionThis study revealed sources of influence on nurses' CPE choices and professional learning pathways, such as sociocultural expectations for women to assume most family responsibilities. Structural influences within healthcare and regulation exert considerable influence on nurses' CPE and learning pathways to align with system needs. This study highlighted the limitations of these influences and the need for CPE programs and learning for nurses that enable rather than constrain their continued professional development.

BackgroundPregnancy loss remains an invisible tragedy that impacts on the psychosocial well-being of women and their families. Cultural norms and beliefs about pregnancy loss affect how some women respond and process the loss. Yet research about Black Canadian women's experiences of pregnancy loss is lacking. The purpose of this research was to explore Black Canadian women's experiences and responses to pregnancy loss.MethodsA descriptive exploratory qualitative design was used to gain insight into the experiences of Black Canadian women. Semi-structured interviews were conducted with women who identified as Black. Data was analyzed using a thematic analysis approach.ResultsWe purposely recruited and interviewed 32 Black Canadian women who experienced miscarriage, stillbirth, or neonatal death. Three overarching themes were identified: (a) coming to terms with the reality of losing a pregnancy, (b) grappling with the psychosocial burden of losing a pregnancy, and (c) navigating for support after losing a pregnancy.ConclusionAddressing the psychosocial burden of pregnancy loss is critical to promote the well-being of Black Canadian women. Nurses and other healthcare providers must recognize that the impact of pregnancy loss extends beyond the immediate clinical concerns. Therefore, intervention programs and follow up care must take a holistic and culturally responsive approach to address the needs of Black Canadian women beyond the period of the loss.

BackgroundPrediabetes is a major risk factor for type 2 diabetes (T2D) and cardiovascular disease. Although prediabetes is associated with chronic stress-related behavioral and physiological maladaptation, few studies have focused on chronic psychological stress.PurposeThis study aimed to examine the feasibility and preliminary outcomes of Emotional Awareness and Expression Treatment (EAET) adopted and implemented among adults with high risk for prediabetes.MethodThis study used a prospective, within-subjects, repeated measures, uncontrolled design with a 4-week virtual intervention period and three measurement points for all participants: baseline, 3 months from baseline, and 6 months from baseline. Forty individuals were screened for prediabetes, and sixteen were eligible to participate. Divided into three groups, participants received four weekly virtual sessions of EAET. Glycated hemoglobin (A1C) and insulin secretion (C-peptide) were measured at baseline, 3- and 6-month periods in addition to self-reported eating habits, physical activity, and perceived stress.ResultsTwelve participants completed all sessions and were fully engaged in the intervention sessions. Across the study period, participants' perceived stress and unhealthy eating habits decreased significantly. Glycated hemoglobin (A1C) showed a non-significant drop at 6 months, but the average C-peptide concentration, exercise frequency, and exercise duration increased significantly.ConclusionsThe EAET stress reduction intervention is feasible and showed promising results in reducing stress and decreasing risk factors for T2D. EAET can be further developed to reduce the incidence and prevalence of T2D, which could lead to a significant decrease in the direct and indirect health and cost burdens of T2D.

BackgroundIn 2022, Ontario colleges and universities reported an estimated 67 vacant full-time nursing faculty positions, driving significant recruitment of nurses directly from clinical practice. Many of these nurses transition to academia lacking the necessary pedagogical preparation and socialization for a faculty role, leading to feelings of inadequacy, stress and an increased intent to leave their positions.ObjectiveThis qualitative descriptive study explored nurses' experiences as they transitioned into the professor role to identify strategies to decrease transition stress, improve career satisfaction, and decrease early-career nursing faculty attrition at Ontario colleges.MethodsData were collected in semi-structured interviews with nine participants from Ontario colleges offering the Bachelor of Science in Nursing degree and analyzed using Conventional Content Analysis.ResultsStudy findings detailed their emotional experiences, diverse preparations before becoming a professor, and the challenges navigating their new role. The study provided three major themes: 1) emotional aspects of the transition experience, 2) preparation for the nursing professor role, and 3) navigating the role and college setting. Nursing professors desired improved orientation programs, formal mentorship opportunities and socialization to the nursing professor role.ConclusionThe findings underscore the need for evidence-informed orientation programs that provide comprehensive training in institutional policies, nursing pedagogy, and support in adapting to the academic culture. These findings can guide Ontario colleges in offering standardized orientation programs that support nurses' excelling as professors and improve retention of this important group.

BackgroundThe COVID-19 pandemic exposed nurses to new and more severe workplace stressors; exposure to these workplace stressors has exacerbated nurse turnover. Nurses working in mental health and substance use (MHSU) have also experienced the unique stressor of the overdose crisis in British Columbia (BC). MHSU nurses have been at the forefront of working to manage these dual emergencies. There is limited evidence related to the compounding effect of COVID-19 and the overdose crisis on nursing turnover. Understanding the unique conditions that MHSU nurses are currently experiencing and what factors influence a nurse's intention to stay in or leave a healthcare facility is essential in developing strategies to minimize turnover and maximize retention.PurposeTo explore the factors that affect nurse turnover while working through the dual emergencies within a MHSU facility in BC, Canada.MethodsA qualitative descriptive approach with an inductive, descriptive thematic analysis guided this quality improvement project.ResultsFindings were grouped into two main themes: reasons for leaving and reasons for staying. Reasons for leaving included workplace safety, seeking new opportunities, lack of support, and being short-staffed. Reasons to stay encompassed connections with clients, leaders and colleagues, support from colleagues and leaders, and feeling valued, safe, and heard.ConclusionsPerceived personal safety and protection from workplace violence were found to increase the likelihood of intent to leave and turnover among nurses. Further, psychosocial safety and connection among nurses and health leaders were found to decrease the likelihood of turnover.

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.