Nursing / Science infirmière - Master's Theses

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    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.
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    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.
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    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.
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    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.
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    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.
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    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.
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    Use of population-based data to characterize racialized and non-racialized Ontarians who self-report a past hysterectomy
    (2021-05-18) Budhwani, Meagan
    North American researchers report that women who undergo a hysterectomy for benign conditions are threatened by health disparities. Few studies have examined race and health in Ontario women who underwent a past hysterectomy. The purpose of this descriptive correlational study was to describe and compare health features of racialized and non-racialized women. Using the 2011-2012 Canada’s Community Health Survey (CCHS) dataset, this study’s sample consisted of all Ontario residing female respondents (n = 1,730) who self-reported having had a hysterectomy with no cancer history. Extracted socio-demographic and health-related variables were extracted in accordance with the Gender and Equity Health Indicator Framework (Clark & Bierman, 2009). Chi-squares and z-scores were calculated to compare racialized and non-racialized women health indicators. Many of the significant differences were found within the non-medical determinants of health domain. Study implications reinforce the need for aggregated data by race in Ontario to address health equity.
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    Pain assessment and management for people with dementia in long-term care in Ontario
    (2021-03-09) Hamilton, Danielle
    Providing nursing care for people with dementia and pain has many challenges. The studies completed for this thesis explore the depths of these challenges by analyzing the concept of nurses’ clinical judgment in caring for this population, as well as through the analysis of resident assessments conducted in long-term care facilities in Ontario. By understanding clinical judgment as well as patterns from resident assessment data, nurses can better understand the steps required to provide adequate pain management for people with dementia. The findings show that long term care residents with dementia who have untreated pain exhibit several behavioral indicators of pain. This supports the creation of policies and best practice guidelines that include a tailored assessment of pain using specialized knowledge and tools. These studies strive to improve the quality of life of residents living with dementia and pain by improving pain management through proper assessment and intervention.
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    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.
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    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.
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    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.
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    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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    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.
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    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.
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    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
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    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.
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    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.
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    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.
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    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.
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    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.