Canadian Journal of Nursing Research最新文献

Background and purpose: Evidence suggests that Gender-based violence (GBV) is prevalent throughout the perinatal period. Women during this time have frequent contact with healthcare providers (HCPs), and there are many opportunities that HCPs can identify GBV and support women by early intervention during routine prenatal care. However, evidence shows that HCPs are still hesitant to address this issue. This study was conducted to explore the experiences of Survivors and HCPs on how to manage a meaningful conversation about GBV with survivors during perinatal care.

Methods: A thematic approach has been used in this qualitative study.

Results: Twenty-eight semi-structured interviews were conducted with survivors and HCPs. Three main themes emerged from the data analysis, including: "Knock gently on the door to enter the client's private world", "Show interest in clients' stories that are beyond their physical problems" and "Gradually and cautiously cross the hidden borders."

Conclusion: HCPs play a pivotal role in identifying GBV and providing support for survivors, particularly during their perinatal period. However, initiating a conversation around this sensitive topic needs time, skill, and enough knowledge. Validating survivors' experiences, providing a private and safe atmosphere without judgment, and creating empathy could lead to more disclosure of GBV. To have a meaningful conversation, HCPs need to have a holistic approach toward care, show interest in clients' stories beyond their physical problems, and support clients who have shared sensitive information.

Background: Single room maternity care (SRMC) includes all aspects of the birth process (labour, delivery, postpartum) in a single room with a consistent team of healthcare providers. Traditional maternity care (TMC) involves having mothers labouring and delivering their baby in one room and then transferring to a room on another unit, which also means a transition in providers. Although many hospitals have transitioned to SRMC, there has been limited evidence to support their development.

Methods: This study was conducted in two large hospitals (one offering SRMC, the other TMC) in Western Canada. A cross-sectional between-subjects design was used to compare differences between SRMC and TMC. New mothers were asked to complete validated questionnaires. Health information was collected from administrative and health databases. The main outcomes included readiness for hospital discharge, mothers' satisfaction, newborn length of stay, and mother length of stay. Several covariates were examined.

Results: In total, 506 (292 SRMC; 214 TMC) mothers participated. Readiness for discharge and maternal satisfaction were significantly higher in SRMC. Although newborn and mother length of stay were significantly reduced in SRMC compared to TMC for univariate tests, mother length of stay was not significantly different when adjusting for other variables.

Conclusions: There are positive health and psychosocial outcomes for mothers and newborns in the SRMC model of care compared to TMC. Since readiness for discharge and satisfaction are associated with positive maternal-infant interactions and transitions to community, SRMC could be the better approach. Further research should examine healthcare provider outcomes and implementation costs.

Background: South Asians make up a significant portion of the immigrant population in Canada, and a large portion of them are in their midlife. To improve the midlife transition of South Asian immigrant women, it is necessary to understand their lived experiences.

Purpose: Guided by the transition theory, this study investigates the midlife experiences of South Asian immigrant women in Canada.

Methods: Twenty-two South Asian midlife, immigrant women were recruited to participate in this study from the Greater Toronto Area, Ontario, Canada. This study consisted of one asynchronous online focus group with 12 participants and ten one-on-one telephone interviews. Qualitative content analysis was guided by transition theory.

Results: South Asian immigrant women experienced many different transitions in their midlife in Canada. These transitions included changes in their (a) lifestyle, (b) career, (c) family, (d) physical health, (e) mental health, (f) social, (g) environment, and (h) personal development. Women actively managed their transitions using strategies such as exercise, socialization, counseling, and religion. Women expressed the need for social, community, and governmental support to facilitate their midlife transitions.

Conclusion: To promote healthy midlife transition, governments need to create better employment policies to facilitate immigrant women settlement, transferring skills, and re-employment in Canada. In addition, health care and community services to promote physical and mental health should be emphasized.

Background: The rising rates of anti-Asian sentiments has recently been called into question by several community activists and scholars. While this collective work has heightened awareness to address anti-Asian racism, the experiences of Asian healthcare workers in particular remains limited.

Purpose: To map the existing literature on anti-Asian racism experienced by Asian healthcare workers in North American healthcare settings, identify gaps in the current literature base, and inform future areas of anti-Asian racism research.

Methods: A scoping review following Arksey and O'Malley's (2005) methodology with updated guidance by Levac et al. (2010) and Peters et al. (2020) was undertaken.

Findings: A total of 3565 articles from database searches were identified from eight databases, with 64 full text articles screened and 15 articles included in this review. Anti-Asian racism amongst healthcare workers has been conceptualized, studied, and understood in three broad categories: levels of racism, descriptions of anti-Asian racism, and the impact of racism. In 60% of the included articles, interpersonal level of racism was solely studied, while 40% articles simultaneously studied interpersonal and institutional levels of racism. Anti-Asian racism was described through three key perspectives: otherness, inferior professional status, and general racial discrimination. Lastly, the impact of Asian healthcare workers' experiences of anti-Asian racism was studied by exploring the impact on mental health and barriers to career advancement.

Conclusion: Despite the presence of anti-Asian racism, the limited literature examining the complexities of the experiences of anti-Asian racism for Asian healthcare workers is concerning. Future scholarship requires further investigation that comprehensively explores the multiple pathways of anti-Asian racism, the contestation of monolithic stereotypes, and how Asian healthcare workers negotiate both hypervisibility and invisibility within healthcare spaces.

Background: Islamophobia or, anti-Muslim racism, and more specifically, gendered islamophobia targeting Muslim women who wear a hijab is rising globally and is aggravated by the COVID-19 pandemic. However, anti-Muslim racism is not well understood in Canadian nursing.

Purpose: This study utilized narrative inquiry to understand anti-Muslim racism through the experiences of nurses who wear a hijab with the goal of putting forward their counter-narrative that disrupts anti-Muslim racism in Canadian nursing.

Methods: Narrative inquiry informed by Critical Race Feminism, care ethics, and intersectionality were used to analyze the factors shaping anti-Muslim racism and composite narratives were used to present the results.

Results: The three composite narratives are: 'This is Who I Am: A Muslim Nurse with a Hijab and an Accent'; 'I Know What is at Play: Unveiling Operating Power Structures and Power Relations'; and 'Rewriting the Narrative: Navigating Power Structures and Power Relations'. These composite narratives constituted the nurses' counter-narrative. They revealed intersections of gendered, racial divisions of labour and religious narratives that shape anti-Muslim racism, as operating power relations in nursing, and how Muslim nurses reclaimed control to resist their racialized stereotypes.

Conclusion: Findings suggest that anti-Muslim racism in nursing operates through multiple intersecting power relations. Using stories can mobilize transformational change so that anti-racist practices, policies, and pedagogy can be embraced.

Background: Emergency nurses commonly conduct geriatric assessments in the emergency department (ED). However, little is known about what geriatric syndromes or clinical presentations prompt a nurse to document an identified need for comprehensive geriatric assessment (CGA).

Objectives: To examine the association between geriatric syndromes, like frailty, and a nurse-identified need for a CGA following emergency care.

Methods: We conducted a secondary analysis of a multi-province Canadian cohort from the InterRAI Multinational Cohort Study. We collected data at ED registration from patients 75 years of age and older (n = 2,274) from eight ED sites across Canada between November 2009 and April 2012. Geriatric syndromes were assessed by trained emergency nurses using the interRAI ED Contact Assessment; and we retrospectively calculated the ED frailty index. We employed binary logistic regression to determine the adjusted associations between geriatric syndromes and a nurse-identified need for a CGA.

Results: Approximately one-quarter (28%) of older adults were identified to need a CGA following emergency care. A 0.1 unit increase in the ED frailty index increased the likelihood of a nurse identify a need for CGA (RD: 6.6; 95% CI = 5.5-7.9). Most geriatric syndromes increased the probability of a nurse documenting the need for a CGA.

Conclusion: When assessed by emergency nurses, the identified need for CGA is strongly linked to the presence of geriatric syndromes, including frailty. We provide face validity for the continued use of emergency nurses for screening and assessing older ED patients.

Background: The COVID-19 pandemic and the quarantine measures implemented have profoundly impacted parents and families. The stress and uncertainty generated by the COVID-19 virus, as well as the disruption of routines and social relationships, have weakened both individual and family health and functioning.

Objective: The present research is part of a larger study that aims to understand, with a family systems theory, the longitudinal effects of the COVID-19 pandemic on school-aged children, adolescents, and their parents. More specifically, this paper aims to investigate parents' experience of the first months of the pandemic as a predictor of perceived social support, parental ill-being (aggregate score of well-established poor psychological functioning indicators), parental satisfaction, and family functioning.

Method: During the first lockdown (April-May 2020), 203 parents of school-aged children living in Quebec completed an online questionnaire.

Results: Path analysis indicates that the impact of COVID-19 and health preoccupation due to COVID-19 are both positively associated with individual parental ill-being, which in turn detracts from family functioning and parental satisfaction. Furthermore, perceptions about positive effects of the pandemic are negatively associated with parental ill-being, and positively with perceived social support, which in turn significantly contributes to family functioning and parental satisfaction.

Conclusion: The findings highlight the importance of adopting a systemic perspective to best understand the effects of the pandemic and the social and health measures on individuals, families, and systems, as well as to better support parents and family health through periods of uncertainty.

Background: Supportive parenting programs can promote parent-child interactions and children's development. However, families experiencing vulnerability (e.g., low socioeconomic status) report barriers (e.g., transportation, distrust of researchers) to research participation, and attrition rates of 40% and higher have been reported in parenting research. In response, we conducted a longitudinal evaluation of a digital parenting program in a major metropolitan centre in western Canada and retained 99% of our sample.

Aim: Review recruitment and retention strategies employed in the First Pathways study and evaluate associations between sociodemographic (e.g., income) and psychosocial (e.g., parental depression) factors with recruitment and retention strategies.

Methods and findings: In collaboration with community agencies, we commenced recruitment of 100 families experiencing vulnerability (e.g., low-income) in June 2021. We utilized strategies to engage staff (e.g., presentations, gift cards, updates) and employed snowball sampling. Families recruited through community agencies were significantly more likely to experience vulnerability (e.g., low income and education, high adverse experiences) compared to families in the snowball sample. We incorporated strategies to minimize participant burden (e.g., choice of online or in-person meetings), promoted rapport (e.g., holiday texts, nonjudgmental environment), incorporated trauma-informed practices (e.g., sensitive inquiry), and demonstrated appreciation for participants' contributions (i.e., honorarium). Family experiences of vulnerability (i.e., low income, depressive symptoms, adversity) were correlated with higher participant rescheduling.

Conclusion: Nurses need knowledge of strategies to promote equitable access to research for families experiencing vulnerability. Digital programs with protocols designed to establish rapport, include trauma-informed practices, and minimize participant burden will likely optimize participation and retention.

Background: The three-month health insurance waiting period in Ontario reinforces health inequities for newcomer women and their babies. Little is known about the systemic factors that shape newcomer women's experiences during the OHIP waiting period.

Purpose: To examine the factors that shaped newcomer women's experiences with perinatal care during the three-month health insurance waiting period in Ontario, Canada.

Methods: This qualitative study was informed by an intersectional framework, and guided by a critical ethnographic method. Individual interviews were conducted with four newcomer women and three perinatal healthcare professionals. Participant observations at recruitment and interview sites were integral to the study design.

Results: The key systemic factors that shaped newcomer women's experiences with perinatal care included social identity, migration, and the healthcare system. Social identities related to gender, race, and socio-economic status intersected to form a social location, which converged with newcomer women's experiences of social isolation and exclusion. These experiences, in turn, intersected with Ontario's problematic perinatal health services. Together, these factors form systems of oppression for newcomer women in the perinatal period.

Conclusions: Given the health inequities that can result from these systems of oppression, it is important to adopt an upstream approach that is informed by the Human Rights Code of Ontario to improve accessibility to and the experiences of perinatal care for newcomer women.

Background: This article reports an evaluative replication study, including a workshop inspired by Paulo Freire's critical pedagogy. Purpose: Assess how the nursing students' participation in critiquing Canadian empirical evidence on men's health literacy provokes new perceptions; explore students' intentions of incorporating the aforementioned contents into their professional practice; and test students' skills to formulate a hypothetical short action plan about men's health literacy.

Methods: A qualitative evaluation study inspired by the qualitative program evaluation approach. The setting was a university-based Canadian undergraduate nursing program located in a major metropolitan city. Seventeen undergraduate students (representing 3.65% of year 4 student population) composed the sample. The educational intervention was two workshops (6 h duration; February 2017) including a lecture about men's health literacy with video presentations, class discussions and group work using Freire's method of reflection and discussion for awareness awakening. Hypothetical health literacy promotion was the key outcome. All interactions were digitally audiorecorded, verbatim transcribed and submitted to thematic analysis having as themes: Perspectives of awareness and knowledge expansion, and New personal-professional assets.

Results: Students were able to relate new knowledge with their own experiences in the classroom or in the practicum. Application of new knowledge was related to students' social circles and reported familiar health matters. Cultural and community life shaped knowledge expansion and references to men's behaviors.

Conclusions: Mobilization of personal knowledge awoke students' awareness about gaps in the nursing curriculum and the paucity of experiences in clinical placements relating to men's health literacy.