Master's Theses

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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.
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
Clinical handovers by paramedics in the emergency department: a focused ethnographic study in an urban hospital in Northeastern Ontario
(2021-05-07) Robichaud, Lorraine
Clinical handover is a high-risk communicative process that involves the exchange of clear and concise patient-focused information between healthcare providers during the transfer of professional responsibility and accountability for patient care. When a patient is transported to hospital by Emergency Medical Services the trajectory of their care in the emergency department is influenced by the clinical handover given by a paramedic to a registered nurse. A focused ethnographic study was conducted to explore the process of Emergency Medical Service clinical handover within the emergency department of a small urban hospital in Northeastern Ontario from the perspective of the paramedic. The findings revealed paramedic handover was influenced by the communication context including attitude of attention and assurance, both reflected in the professional dynamic between the paramedic and ED staff; the ambience of the ED reflected in the physical layout and activity level of the ED; and the patient acuity reflected in the assigned Canadian Triage Acuity Scale level and frequency of individual visits to the ED. The study provides evidence that paramedics strive to deliver concise, accurate communication of a clinical handover so that ED patients receive safe, competent care and that there is opportunity to improve on the organizational and cultural practices of clinical handover in the ED.
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.
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.
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.
Experiences of families and survivors following a sudden cardiac arrest: a metasummary
(2021-03-29) Janssen, Jessica
An uptake of emerging evidence contributes to increasing survival rates following a sudden cardiac arrest. Life after survival often involves a myriad of altered physical, mental, cognitive, and social functions for both survivors and their families. The study purpose was to aggregate published qualitative evidence to yield an understanding of survivors' and family members' life experiences following cardiac arrest. Using metasummary, 17 international published studies were selected. The extraction, editing, and abstraction of findings from 230 adult participants resulted in eight topical categories including: acknowledging life has changed, confronting mortality, regaining former life, interacting within the family, interacting within the broader social context, involving healthcare providers, evolving health status, and enacting a new life. The two themes were seeking wholeness and being connected. Healthcare providers are urged to prioritize the development and implementation of resourced individualized discharge plans to promote continuity and comprehensiveness of care for survivors and families.
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.
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.
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.
Fall risk factors in long-term care facilities in Ontario
(2021-09-02) Akomah, Abimbola
This research was the first large study in Ontario seeking to assess the fall risk factors of longterm care (LTC) residents. Ontario-wide LTC data were provided by the Canadian Institute of Health Information for the period April 2019 through March 2020. Guided by a positivist philosophical orientation, this thesis consolidated existing fall risk factor research using a literature review; developed a concept analysis on the relationship between homeostasis and falls in older adults; and conducted a cross-sectional, retrospective research study on falls in Ontario’s LTC facilities. The main research question was: What are the factors associated with falls among residents living in Ontario’s LTC facilities? Results showed a significant relationship between variables such as age, sex, diuretic use, visual impairment, dependency in activities of daily living, and cognitive and physical impairments with falls within the previous 30 days. Research results will contribute to the development of more effective falls prevention strategies.
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.
The impact of medical assistance in dying (MAiD) education on the knowledge and the beliefs of students in a french undergraduate nursing program
(2023-04-13) Lindenbach, Monica Eva
Medical Assistance in Dying (MAiD) can bring out positive and negative emotions in nurses. Nurses must feel comfortable with their role, be knowledgeable, and practice their skills according to the laws and regulations. Literature shows that education positively impacts nursing students' knowledge, beliefs, and comfort about MAiD. Although Canadian nurses' have been involved with MAiD since 2016, education in undergraduate programs wasn’t implemented until 2020. This study explored the impact of an education program about MAiD on the knowledge and beliefs of students in the French undergraduate nursing program. A longitudinal quasiexperimental design was used, which was informed by the Theoretical Domains Framework. Findings showed that some sociodemographic factors were significantly associated with knowledge levels. The educational intervention resulted in an increase in knowledge and retention, and impacted beliefs. These results can inform nursing practice, future research, as well as policy development.
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
Les expériences d’allaitement des femmes du district de Témiskaming
(2021-01-26) Manners, Angie
L’allaitement est le moyen le plus naturel de nourrir son enfant et lui fournir toutes les propriétés immunologiques nécessaires à un bon départ. L’Organisation mondiale de la santé (OMS) et les Fonds des Nations Unies pour l'enfance (UNICEF) (2018) réitèrent l’importance pour tous les bébés d’être allaités exclusivement durant les six premiers mois de vie et la poursuite de l’allaitement jusqu’à deux ans ou plus suite à l’introduction appropriée des aliments complémentaires. Les Services de santé du Timiskaming1 (SST) ont reçu la désignation Amis des bébés (IAB) en mars 2017. Depuis, le taux d’initiation d’allaitement a diminué, et ce, de façon statistiquement significative du taux provincial. Cette étude à devis mixte vise à connaître les pratiques d’allaitement des femmes du district de Témiskaming et démontre que seuls le tabagisme et l’éducation de la mère ont une association avec la durée d’allaitement. Malgré que certaines des Dix2 conditions selon l’IAB se maintiennent au-delà de 80% de succès, autres variables, selon les résultats, ne rencontrent pas ces critères. Un travail intentionné avec les agences communautaires sur des initiatives établies et nouvelles, incluant le cheminement vers la désignation IAB seraient bénéfiques pour connaître davantage les besoins des mamans et d’augmenter la durée d’allaitement.
Limites des apprentissages au laboratoire des sciences infirmières : l’apport d’une grille d’évaluation pour offrir des soins holistiques en situation linguistique minoritaire
(2020-05-01) Giguère, Lisa
Dans le souci d’arrimer la théorie à la pratique en sciences infirmières, le programme des sciences infirmières de l’Université Laurentienne offre aux étudiantes l’apprentissage des techniques des soins (TDS) au laboratoire avant d’être avec les patients/clients, en situation réelle. Pour s’assurer que les étapes de la TDS apprises étayent les soins holistiques du patient/client, la présente étude développe une grille d’évaluation d’apprentissage de TDS intégrant la philosophie de soin holistique et répondant aux besoins des étudiantes francophones en situation linguistique minoritaire. Pour élaborer une nouvelle grille d’évaluation répondant à ces besoins, cet outil est constitué de 5 catégories et composés de 22 critères de performance. Ainsi, de professeures et enseignantes, se sont prononcées sur la pertinence et le contenu de l’instrument utilisant la technique du groupe nominal et la technique Delphi; les techniciennes de laboratoire sur la fidélité interobservateurs avec le coefficient de corrélation intraclasse très significatif.
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.
Lived experiences of self-care among adults with inflammatory bowel disease in Northeastern Ontario
(2021-08-31) Lefebvre, Kelsey E.C.
Adults with inflammatory bowel disease (IBD) experience debilitating symptoms that impede their ability to engage in daily activities. In Northeastern Ontario, there is limited access to formal specialized resources inhibiting the development of self-care strategies for living cohesively with IBD. An interpretive phenomenological analysis was used to gain an understanding of the lived experience of self-care among adults with IBD in Northeastern Ontario. Semi-structured interviews were conducted with six individuals diagnosed with IBD. Analysis resulted in the identification of two main themes: living with uncertainty and seeking control. The four subthemes included: disease uncertainty, formal care uncertainty, self-directed resourcefulness, and self-developed observational skills. The lived experience of self-care found to be the actions undertaken to live with uncertainty and seek control in the context of inflammatory bowel disease. The findings align with the Theory of Self-care of Chronic Illness, and provide new insights into potential improvements in patient-centered care, the importance of informal resource utilization, and describe how adults living with IBD in Northern communities navigate their illness through self-care.
L’expérience d’un échec à l’examen professionnel infirmier NCLEX-RN des diplômées du programme francophone de baccalauréat en sciences infirmières
(2021-09-02) McGee, Shannon
Afin de devenir infirmière en Ontario, les diplômées d’un programme de sciences infirmières doivent réussir un examen d’admission à la profession pour obtenir leur permis d’exercice. En 2015, l’examen canadien a changé de format et il est devenu similaire à celui des États-Unis, soit le « National Council Licensure Examination – Registered Nurse » (NCLEXRN). Les premiers résultats canadiens à l’examen d’admission à la profession infirmière NCLEX-RN ont démontré de nombreux échecs, qui touchaient davantage les francophones que les anglophones. L’échec à un tel examen peut être dévastateur pour les candidates, tant sur le plan professionnel que personnel. Les candidates qui ne réussissent pas l’examen NCLEX-RN peuvent devenir déprimées et isolées et subir des difficultés financières. De plus, le parcours de la vie ainsi que leur perspective d’emploi sont souvent remis en question. Puisque le phénomène d’un échec à l’examen NCLEX-RN canadien auprès d’une population francophone reste encore peu connu, à l’aide d’une approche phénoménologique, l’expérience de cet échec est expliquée par des diplômées du baccalauréat en sciences infirmières francophones de l’Université Laurentienne (UL) de Sudbury. Les participantes ont été recrutées à l’aide d’un échantillonnage non-probabiliste, notamment l’échantillonnage de convenance. Les données ont été recueillies à l’aide d’entrevues individuelles semi-dirigées. Les résultats de cette étude ont démontré que les participantes francophones ont vécu des difficultés supplémentaires lors de la préparation et lors de l’examen NCLEX-RN peu importe la langue choisie qui, entre autres, est reliée à un ou plusieurs échecs de cet examen.
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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