Nursing / Science infirmière - Master's Theses

Permanent URI for this collectionhttps://laurentian.scholaris.ca/handle/10219/2058

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The implementation of a structured format of brief cognitive behaviour therapy (CBT) methods to overcome the barriers and facilitate the delivery of CBT by primary healthcare providers for patients with depression: a pilot evaluation
(2013-09-11) Barban, Karen
Cognitive behaviour therapy is a well-documented first-line treatment for mild to moderate depression. Primary healthcare providers have encountered several barriers when trying to provide CBT in an office-based setting and as such, adoption of this evidence-based treatment has been suboptimal. Primary healthcare nurse practitioners (PHC NPs) have an in-depth knowledge of advanced nursing practice, and are responsible for the assessment, diagnosis and management of patients with acute and chronic conditions, such as depression. PHC NPs are also ideally situated in the health care system to deliver CBT to their patients. The objectives of this project were to develop a format for the delivery of brief CBT methods that was feasible in the PHC setting, increase PHC providers’ confidence to implement CBT and ultimately increase their adoption of CBT
Attitudes of registered nurses, allied health professionals, and clerical staff towards multi-disciplinary teamwork
(Laurentian University of Sudbury, 2013-10-08) Guido, Pina Rita
Although teamwork is essential for quality care, outcomes based on successful teamwork are seldom achieved in healthcare. Negative attitudes prevent effective teamwork; therefore, it is important to explore attitudes of all members towards multi-disciplinary teamwork. This research investigated attitudes held by health professionals and staff of the Group Health Centre regarding multi-disciplinary teamwork and investigated if a relationship exists between work experience and attitudes towards teamwork. A descriptive correlational design was used. Data was gathered using the TeamSTEPPS Teamwork Attitude Questionnaire (T-TAQ). The T-TAQ assesses attitudes towards validated constructs of teamwork. Team members of the Group Health Centre have positive attitudes towards teamwork. The registered nurses do not have different attitudes compared to their colleagues from other health sciences or staff. However, clerical staff presents differences with respect to the constructs of situation monitoring and communication. There is no relationship between work experience and attitudes. These results have important implications for teams in primary care, specifically, the Group Health Centre.
Design, construction and validation of internal organ phantoms for biomechanical testing
(Laurentian University of Sudbury, 2013-10-08) Omri, Karim
This thesis includes the development, construction and testing of internal organ phantoms, with focus on the liver, for biomechanical testing. Phantoms have various biomedical applications such as surgical simulations, minimally invasive surgery, soft tissue characterization, diagnostic tools and instrumentation calibration. However, there is little work present in literature regarding phantoms and the work that is currently available does not account for the non-linear viscoelastic properties as well as the Glisson’s capsule. In this work, three different phantoms are presented: a fluid-filled phantom, a perfused phantom and a hydrogel-based liver phantom. A testing apparatus is designed, built and used to measure the force-displacement data during the indentation of the phantom. The first phantom that is designed and constructed follows the basis of a fluid-filled vessel. It is composed of a linear low-density polyethylene (LLDPE) bag filled with different fluids namely: water, a 1:1 water/glycerine mixture and glycerine. The phantoms are subjected to quasi-static loading as well as relaxation testing. The effect of density and viscosity, its size, and confined and unconfined boundary conditions are characterized. The second phantom is designed to investigate the effects of hepatic macrocirculation on the biomechanical properties of the liver. The phantom is made of two-part silicone (Smooth-On, ECOFLEX 00-30), and contains a network of conduits to model the large ! iv! blood vessels in the liver. A perfusion system that captures the general features of the human hepatic circulation is used to help investigate the effects of the different flow parameters such as pressure and flow rate on the biomechanical characteristics of the liver. The perfusion system is designed to reproduce comparable pressures to the human portal vein and hepatic artery. The third phantom is made of two parts, a hydrogel inner layer with a LLDPE outer layer. The idea behind this phantom is to represent the organ as accurately as possible by accounting for the capsule that surrounds the organ as well as the biphasic (solid and fluid) nature of the organ. A biphasic poroviscoelastic model is used to model the hydrogel while the LLDPE uses a non-linear hyperelastic and viscoelastic model. Modeling is done in ABAQUS to fit the experimental data obtained from quasi-static indentation and relaxation testing using a parametric study. In conclusion, phantoms replicating the non-linear viscoelastic properties observed in organs are presented and characterized. Main Thesis Contributions • Development and characterization of a simple fluid-filled phantom to represent the mechanical properties of the liver • Development and characterization of hydrogel-based liver phantom with representation of the biphasic nature of the organ and the Glisson’s capsule. ! v! • Development and characterization of perfused liver phantom with ability to be recreated with various vessel configurations. • Development of testing set-up to characterize various phantoms.
Teamwork and staffing in an acute care hospital
(Laurentian University of Sudbury, 2014-08-14) Rochon, Andrea
The literature suggests that teamwork among patient care teams can have positive effects on work environment, job satisfaction, and quality of patient care. The purpose of this study was to determine the perceived level of nursing teamwork by registered nurses, registered practical nurses, personal support workers, and unit clerks working on patient care teams in one acute tertiary care hospital in northern Ontario, and to determine if there is a relationships between the staff scores on the Nursing Teamwork Survey (NTS) and participant perception of adequate staffing. Using a quantitative descriptive cross-sectional research design, 600 staff were invited to complete the NTS with a 33% response rate (N=200). The participants from the critical care unit reported the highest scores on the NTS, while participants from the inpatient surgical (IPS) unit reported the lowest scores. Participants from the IPS unit also reported less experience, less satisfaction in their current position, and a higher intention to leave. No statistically significant correlation was found between scores on the NTS and the perception of adequate staffing. Strategies to increase teamwork among patient care teams may positively influence job satisfaction and patient care on patient care units.
Factors contributing to the non-urgent use of the emergency department by Canadian triage and acuity scale IV and V patient in Sudbury, Ontario
(Laurentian University of Sudbury, 2014-10-07) Askin, Christine
In Canada, it is estimated that 57% of all emergency department (ED) visits are for less-urgent or non-urgent care needs (Hodgins & Wuest, 2007). Factors that contribute to the non-urgent use of ED services include lack of resources, insufficient access to care, and lack of awareness regarding available health care options (Fieldston, Alpern, Nadel, Shea & Alessandrini, 2012). The goal of this quantitative descriptive design study was to determine the relationship between having access to a primary health care provider, utilizing community based health care supports, and the patient’s perception of illness, with the adult patient’s decisions for presenting to the ED with nonurgent care needs. Of the 119 respondents, 71.3% had access to a primary health care provider. A majority of the respondents (70.1%) perceived the threat of their illness as moderate. Those without registration with a primary care provider had a significantly higher perceived threat of illness than those with a primary care provider. Results indicate that 72.6% of respondents presented to the ED because of a perceived urgency of need for care, and 48.7% of participants came to the ED because they thought they required ED services. Identifying why people present to the ED with non-urgent care needs can assist health care providers and decision makers to enhance their understanding of the patient’s expectations of health care services and their perception of illness.
A scoping review of fathers with mental illness
(Laurentian University of Sudbury, 2015-01-23) Baker Devost, Anne-Marie
Purpose: The purpose of this study was to examine the nature of the evidence addressing the fathering practices of men living with mental illness. Method: A scoping review methodology, guided by the protocol of Arksey and O’Malley (2005), was used. Literature published between January 1, 2002 and December 31, 2012 was retrieved and 33 reports were extracted, aggregated and summarized. Findings: Fathering practices were comprised of seven main topical categories: illness as impediment to fathering; non-illness impediments to fathering; father-mother relations; external informal and formal supports; availability of father to child; involvement of father with child; and, fathering for health, though rarely are fathering practices related to health outcomes. Conclusions: The nature of the evidence reviewed illustrates the diversity of the current literature with little uniformity across the studies. Several gaps in research on fathers with mental illness continue to exist including research on paternal practices and associated health outcomes.
The lived experience of a changing relationship with tobacco: a perspective of individuals with serious mental illness
(Laurentian University of Sudbury, 2015-02-26) Allen, Janet
Individuals experiencing serious mental illness (SMI) have significantly higher rates of tobacco use and although motivated to quit smoking are less successful with quit attempts thus increasing their risk of chronic disease. A qualitative hermeneutic phenomenological study that included photo elicitation was used to gain an understanding of what the lived experience of a changing relationship with tobacco means to those living with SMI. Interviews with nine individuals with varying diagnoses of SMI, and at various stages of changing their tobacco use behaviour were interpreted to reflect six themes of the phenomenon. The findings align with the core concepts of the Trans-theoretical Model and also parallel the consumer driven concept of recovery in mental illness. The mental health care provider’s integration of tobacco cessation into practice using a recovery model approach, may serve a dual purpose of improving quit smoking rates as well as supporting the individual’s recovery in mental illness.
The experiences of adults living with epilepsy : an interpretive description
(2015-04-17) Bilinsky, Laryssa M. E.
A qualitative interpretive description study was conducted to explore adults’ experiences of living with epilepsy. Adults integrate epilepsy into their daily lives; however, there is dearth of literature that explores their lived experiences. Semi-structured interviews were conducted with nine participants recruited from two health clinics situated in northern Ontario, Canada. The main theme was epilepsy as a temporal journey accompanied by others who knew of their past and present experiences, and future aspirations. The past included the onset of epilepsy and accompanied losses. The present was the balance between threats and well-being. Envisioned future was facilitated by hope. Each subtheme built upon the preceding in an attempt to create well-being and strive towards their envisioned future. Suggestions for nursing practice include fostering understanding in the past, promoting the creation of well-being in the present, and inspiring hope towards the future envisioned life.
Identifying ICU patient safety priorities within a Northern Ontario setting : a delphi study
(2015-10-08) Bloomfield, Tiina
The purpose of this study was to explore patient safety priorities as perceived by clinical experts working in a northern Ontario adult ICU. A modified Delphi was used to elicit consensus regarding patient safety priorities from the perspective of an expert panel of registered nurses and intensivists. At the onset of the study, the consensus level was set at 70%. Data was collected through serials rounds with researcher-developed questionnaires. Descriptive statistical analysis was completed. No consensus was reached at Round 1. Three points of consensus regarding patient safety priorities were reached at Round 2: improving pain and agitation management; incorporating a checklist into the bullet round reporting tool; and implementing use of visual cues for high-risk lines. These strategies support the need for anticipation, recognition, and management of at risk situations. The results have the potential to guide the advancement of the patient safety mandate within an ICU setting.
Nursing processes related to unplanned intensive care unit admissions
(2015-11-12) Martin, Jennifer
Timeliness is an important factor in the care of critically ill patients on the general wards in order to prevent an unplanned intensive care unit admission. The recognition of patient deterioration can be influenced by many factors. This study looks specifically at how communication, documentation and the recognition of patient deterioration affect unplanned intensive care unit admissions. Unplanned intensive care unit admissions may result in higher rate of mortality, longer lengths of stay and a prolonged recovery post discharge. The goal of this retrospective quantitative research study is to explore how communication, documentation and recognition of patient deterioration are utilized by nurses in order to help prevent an unplanned intensive care admission. This study was guided by the Nursing Role Effectiveness Model which considers how structures and processes lead to outcomes and has been utilized in many quality improvement initiatives. Communication, documentation and recognition of patient deterioration are key components that nurses can use to improve upon patient care. The benefits to preventing patient deterioration are clearly documented. Strengthening communication, documentation and recognition of patient deterioration skills will improve patient outcomes and in turn help to prevent the need for unplanned intensive care unit admissions.
Exploring the relationships among nursing students' anxiety in the clinical setting and select demographics.
(Laurentian University of Sudbury, 2015-11-20) Villeneuve, Pamela
The clinical learning experience is an essential part of nursing education that is often anxiety provoking. Understanding the factors associated with the anxiety levels of nursing students in clinical placements has become more complex over the years with the increasing heterogeneity of the nursing population. Associations between student demographics and their anxiety levels in the clinical setting have not yet been explored in the research literature. The questions guiding this descriptive correlational study are as follows: What is the anxiety level of students as determined by the State-Trait Anxiety Inventory (STAI)? Is there a relationship between students’ age, gender, previous employment, and previous education and their selfperceived anxiety levels? The framework for this study is situated cognition theory. The data provided through the study revealed that nursing students have a higher than average level of anxiety. The data revealed no statistical significant correlations involving age, previous education, previous employment, and self-perceived anxiety levels. There was a statistically significant difference between the anxiety scores of the female group and those of the male group, with males reporting higher levels of anxiety. The data provide an opportunity for discussion and identify the need for future research and practice.
Non-pharmacological prevention of delirium in older adults in long term care: a scoping study
(2016-04-24) Ferguson, Erin
Background: Non-pharmacological multicomponent interventions for the prevention of delirium have been well studied in the acute care setting. Less is known however, regarding this approach in long term care environment. Aim: The purpose was to systematically synthesize evidence pertaining to non-pharmacological nursing interventions for the prevention of delirium among older adults residing in long term care settings. Methods: This study used a scoping review methodology guided by Arksey and O’Malley’s (2005) framework. A total of eight academic databases were searched. In addition, reference lists, clinical guidelines, and key journals were searched. To ascertain the nature of the extracted data from reports meeting specific inclusion criteria, descriptive numerical data analysis methods were used. Findings: Results revealed a total of 13 reports; two clinical guidelines, one systematic review, and 10 primary studies. The reviewed evidence examined single rather than multicomponent interventions for the prevention of delirium in the population of interest. Collectively, the heterogeneous and mixed findings addressed hydration, risk reduction and education of staff. Conclusion: The results were stark in contrast to the established body of work regarding nonpharmacological multicomponent approaches in acute care.
The meaning of home for aging women living alone in North Eastern Ontario
(2016-12-02) Barry, Arro
The experience and meaning of home for older, community dwelling women, was investigated. In the world of gerontology there is a paucity of knowledge about those in their eighth and ninth decade, and this becomes more pronounced among older women. With the older demographic expanding and resources being directed at keeping seniors in their home- a solid knowledge base is required. This study built on the knowledge that exists around home, aging at home, formal care, and the vulnerabilities of aging in two ways. First, the literature around home was synthesized with an evolutionary concept analysis which served to focus further research. Secondly, an interpretive description study added to the knowledge of home by bringing to light the precariousness of formal and informal care and the effect this precariousness has on the meaning of home. The knowledge built in this study has the ability to inform policy, organizations, education, and individual providers as well as highlighting areas for further research.
Dementia informal caregivers’ experience with hospital discharge planning post-discharge
(2018-03-01) Owusua, Adwoa
Little is known about dementia informal caregivers’ experience with discharge planning, and whether the discharge planning hospital team, including the physician, nurse practitioner (NP), social worker (SW), and other allied health practitioners, meet the needs of caregivers both in- and post-hospital. This interpretative phenomenological study examines dementia informal caregivers’ experience with hospital discharge planning post-discharge from an Ontario urban hospital. Five informal caregivers were interviewed using semi-structured telephone interviews, and data was analyzed using Benner’s interpretative analysis process (1985; 1994). Research findings suggest that dementia informal caregivers consider their role as challenging due to many stressors and demands and poor discharge planning. Informal caregivers reveal that information sharing and the arrangement of community resources during the discharge planning process was inconsistent. They felt abandoned and unsupported throughout the discharge plan, as defined by lack of communication and dissemination of caregiver resources. As a result, caregivers had difficulty understanding and managing their loved ones’ health care needs after hospital discharge. Research findings can help inform discharge planning practices and standards as it pertains to dementia informal caregivers.
The experiences of intrapartum nurses in a northeastern Ontario, Canada setting in providing labour support
(2018-06-14) Dobson, Ylise M.
A qualitative, interpretive descriptive study, using a symbolic interactionism theoretical framework, was conducted to explore the experiences of intrapartum nurses in a Northeastern Ontario, Canadian hospital and the meaning they place on providing labour support. There is substantial literature that supports the many benefits of labour support provided by intrapartum nurses. Throughout the intrapartum experience, the nurse influences, creates, and shapes the meaning and understanding of the labour experience. Semi-structured interviews were conducted with eight registered nurse participants recruited from a hospital. Interviews were transcribed and analyzed for themes. The following five themes emerged from the data: Enhancing the birthing experience of women through labour support, birthing technology and medical paradigm, birthing environment that influences the intrapartum nursing care, interprofessional collaborative relationships and intrapartum specialists. The findings suggest that intrapartum nurses have been drawn away from providing labour support and have become preoccupied with managing technology and competing priorities for their time and attention. Barriers and challenges in the experience of nurses providing labour support were identified. Suggestions for nursing practice include the importance of continuing education for labour support techniques and tools. Training is important for all nurses who practice in hospitals where less labour support may be offered due to high intervention rates. Competence validation would include creating a certification for labour support that is both theoretical and a simulated experience.
Parents’ experiences and nurses’ perceptions of decision making about childhood immunization
(2018-09-15) Hosman, Shelly
The uptake of immunization against infectious childhood diseases such as mumps, measles, rubella, diphtheria, tetanus, and pertussis has resulted in positive global health outcomes. The estimated vaccine coverage for these diseases, however, falls below targets recently set by the World Health Organization. The reviewed literature demonstrated that parents have an active role in making decisions about their children's immunization status informed by contextual, individual, and vaccine-specific influences. Few studies addressed nurses' involvement in parental immunization decisions. No qualitative studies could be found that explored Canadian parents' and nurses' perspectives into this complex, contextually-bound phenomenon. The aim of this qualitative study is to understand parents' and nurses' experiences of decision making about childhood immunization, specifically measles-mumps-rubella and/or diphtheria-tetanus-acellular pertussis. Thorne's interpretative description approach was used to facilitate parents' and nurses' sharing of their experiences and perspectives about childhood immunization to capture the relevancy for nursing practice. Results demonstrate that protection was the unifying goal across all parents and nurses. Motivated by protection of their child, parents searched for information about immunization, deliberated the information and sources to determine the relative benefits and risks of immunization, and assumed responsibility for their decision to accept, delay or decline immunization, and accepted responsibility for the consequences of their decision. Nurses described their role as protectors of child safety and population health. Findings of this study suggested that a tension that exists between nurses’ professional obligation to protect the public against vaccine preventable diseases, promote immunization update, yet, respect individual parental choice. Parents desired encounters with health care providers that were open to acknowledging and addressing their concerns in order to protect the health of their child. Future nursing approaches recommended by this study included nurse-led education sessions within a community environment, nurse-led forums that outreach to the public regarding fears and concerns about childhood immunizations, connecting with parents in the community could facilitate better access and improved engagement with health team members, forming partnerships with existing groups, and adding health literacy to the education curriculum could positively impact individual and community health.
Northeastern Ontario registered nurses’ perceptions of E-learning
(2018-12-18) Stevens, Christopher James
Nurses face challenges in meeting their continuing education needs. E-learning can help to overcome these barriers and has become a common method of nursing continuing education. An integrative literature review found that e-learning benefits nurses’ learning, patient care, and the hospital organization in different international contexts. E-learning has unique barriers, areas for improvement, and additional research is needed in the Northeastern Ontario context. An interpretive description qualitative study explored the perceptions of ten Northeastern Ontario registered nurses about e-learning. The aim was to understand this phenomenon and inform continuing education practices. Bridging the Gap was the overarching theme, providing a rich description of how nurses perceived e-learning as a continuing educational method. The overarching theme was supported by the subthemes: Unsatisfactory Learning Experiences, Meaningful Learning Experiences, and Enhancing Learning Experiences. These findings could inform future e-learning continuing education and support patient care.
Risk factors for mode of delivery
(2019-01-15) Briglio, Tiana
Mode of delivery and the effects of birth trauma were investigated. First, a literature revealed the need for further examination of a specific mode of delivery (operative vaginal birth [OVB]). Secondly, an integrative review explored the concept of birth trauma as it relates to healthcare provider actions and behaviours via the following research question: What is known about the relationship between healthcare provider actions and women’s perceived birth trauma? Thirdly, a retrospective study was conducted that built on the literature review to answer the following research question: What infant, maternal, healthcare provider, and regional characteristics put a woman at risk for experiencing an OVB? The final section concludes the project by reflecting on the work completed, interpreting the results for nursing and other healthcare providers, and providing recommendations for future research. This thesis sets the groundwork for future research as it includes the first study to explore unique risk factors for OVB for women in Ontario, Canada. As well as, uncovering the impact that healthcare provider actions and behaviours have on a woman’s birthing experience. The knowledge built in this project has the ability to inform healthcare providers who care for women during the antenatal period, labour and childbirth as well as health policy informing women’s health and wellness.
Centre d'hébergement : traits de personnalité et attitudes de préposées aux bénéficiaires ayant l’intention de rester dans leur milieu de travail
(2019-04-29) Lalande, Kiara
Le vieillissement de la population canadienne a un impact sur les organismes de santé, le nombre de personnes âgées qui ont besoin de soins augmente. Les centres d’hébergement en Ontario ont de la difficulté non seulement à attirer, mais aussi à retenir les préposées aux bénéficiaires (PAB). La présente étude va déterminer les traits de personnalité et les attitudes des préposées qui décident de rester au travail dans les centres d’hébergement. Cinquante préposées de six centres d’hébergement du Grand Sudbury ont complété les questionnaires : le 16 personnality factor de Cattell (16 PF) et le Kogan’s Attitudes Toward Old People Scale (KAOP). De manière générale et selon l’administration de ses deux outils, les PAB de l’étude sont chaleureuses, concrètes, réactives, soumises, spontanées, consciencieuses, timides et objectives. Elles sont vigilantes, perfectionnistes, pratiques, intériorisées, appréhensives, traditionnelles, perfectionnistes et décontractées. Elles sont extraverties, anxieuses, fermées, contrôlées et dépendantes. Tout compte fait, les PAB ont des attitudes positives envers les personnes âgées
L’expérience que les étudiant(e)s francophones inscrit(e)s au baccalauréat en sciences infirmières ont à intégrer l’offre active dans des milieux de stages majoritairement anglophone étude phénoménologique
(2020-04-30) Sckopke, Christina
L’offre active de services de santé en français s’avère une action pour proposer de manière constante et permanente des services en français à la population francophone (Consortium national de la formation en santé, 2013 ; Commissariat aux langues officielles, 2019 ; Office des affaires francophones, 2014). Le consortium national de la formation en santé (CNFS) reconnaît l’importance de l’offre active. Grâce à une subvention du CNFS, l’offre active a été intégrée au programme de baccalauréat en sciences infirmières (B.Sc.Inf.) de l’Université Laurentienne. Les étudiantes* inscrites à ce programme reçoivent une formation en offre active tout au long de leurs études afin d’être capables d’offrir des services en français à la population francophone. En revanche, la majorité de leurs expériences cliniques se déroulent dans des milieux majoritairement anglophones. C’est ainsi que l’objectif de cette étude est de décrire les expériences vécues par des étudiantes francophones d’un baccalauréat en sciences infirmières ayant obtenu une formation en offre active en lien à l’intégration de cette offre lors de leurs expériences cliniques dans des milieux de stages majoritairement anglophones. Cette étude va permettre d’acquérir des connaissances pour mieux planifier l’intégration courante de l’offre active dans le curriculum du B.Sc.Inf. et préparer davantage les étudiantes à offrir des soins de santé en français dans des milieux de stages majoritairement anglophones.

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