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    The use of recovery model in forensic psychiatric settings: a Foucauldian critique
    (2022) Johansson, Jim A.; Holmes, Dave
    Recovery, a model of care aimed at patient-led nursing practice emphasizing autonomy, hope and self-determination, has in recent years been adapted for the secure forensic psychiatric setting. Often referred to as ‘secure recovery’, this model suggests the aims of recovery are achievable even in highly restrictive settings. This paper will adopt a Foucauldian perspective to offer a critical analysis of recovery in forensic settings. In providing recovery-oriented care, nurses utilize pastoral power in guiding patients to institutionally preferred outcomes. Akin to Christian religious conversion, nurses engage in a neo-religious conversion of patients to a neoliberal subjectivity of homo-economicus. This path of recovery is grounded in an ethos of personal responsibility and self-government, inseparable from the greater context of neoliberal governmentality. Despite attempts at transforming forensic nursing practice into more egalitarian directions, recovery remains a coercive practice, and fails to meet the overall goals of this paradigm in secure settings.
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    The clean and proper self: the relevance of Kristeva’s concept of abjection for nursing
    (2022) Johansson, Jim A.; Holmes, Dave
    Nurses regularly encounter feelings of disgust in practice, from bodily fluids and wounds to the criminal histories of patients. Though these experiences are widespread in nursing practice, there exists a culture in which they are regularly and intentionally ignored by nurses, and have received little attention in the literature. French-Bulgarian philosopher Julie Kristeva described these feelings of disgust within her psychoanalytic concepts of abjection and the clean and proper self. When nurses experience abjection, they work to protect and maintain the boundaries of the clean and proper self. This paper will employ a conceptual analysis to explore the implications of abjection and the maintenance of the clean and proper in nursing practice, with a specific focus on forensic nursing. A literature review of scientific articles and monographs addressing issues of disgust and abjection was conducted. The work of Kristeva provides the theoretical framework for this analysis. The analysis illustrates that nurses erect boundaries between themselves and patients, with significant consequences for patient care. An enactment of rituals to avoid the uncomfortable feelings of abjection and an effort to maintain the clean and proper self is widespread in nursing practice. Acknowledging the presence of abjection in nursing practice, recommendations are given on how to both embrace and overcome this experience.
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    Abjection and the weaponization of bodily excretions in forensic psychiatry settings: a poststructural reflection
    (2021) Johansson, Jim A.; Holmes, Dave
    Nurses working in forensic psychiatric settings face unique challenges in practice, where they take on a dual role of custody and caring. Patient resistance is wide-spread within these restrictive settings and can take many forms. Perhaps the most disturbing form of resistance entails a patient's weaponization of their bodily fluids, with nurses as their target. The tendency in assigning motive for this act is to relegate to the psychopathology of the patient. This paper will adopt a post-structuralist perspective to reexamine this phenomenon as an act of resistance through the lens of Kristeva's concept of abjection. Patients confined in these set-tings have little sense of control, and in resistance may resort to the only thing available: their bodily fluids. By weaponizing the abject, patients actively violate and permeate the physical and psychological boundaries of nurses—the very boundaries considered crucial to safe and professional forensic psychiatric nursing practice. By recognizing this phenomenon as an act of resistance to confinement and loss of control, nurses may reorient their approach to care in forensic psychiatric settings.
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    Canada’s aging federal prison population: health disparity, risk, and compassionate release for older persons convicted of sexual offences
    (2023) Johansson, Jim A.; Holmes, Dave; Paradis-Gagné, Etienne
    The Canadian federal prison population is increasingly aging within institutions that were never intended or designed to meet the complex medical and mental health needs of older incarcerated persons. Increasing numbers of incarcerated persons are “aging in place,” and many are dying within federal correctional institutions. Persons convicted of sexual offenses comprise a large—and growing—proportion of this aging population. The Correctional Investigator Canada has recently called for an expansion of access to compassionate release for the aging federal prison population, yet little progress has been made. In this article, we explore the significant challenges faced by the aging population in federal institutions, including insufficient access to appropriate care, challenges in application for compassionate release, and how questions of risk may affect the potential for community transfer. Questions of risk overshadow decisions on early release of incarcerated persons, especially those convicted of sexual offenses. Nurses play a central role in the provision of care to aging incarcerated persons and in advocacy for better access to services when a patient's needs cannot be met within the institution. This article presents a call to action for forensic nurses in Canada (and beyond) to advocate for both improved services within federal correctional institutions and for expedited access to compassionate release of aging incarcerated persons, especially those nearing end of life. The significant disparity in access to health care for aging incarcerated persons compared with their nonincarcerated counterparts represents a significant concern.
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    Undergraduate nursing student satisfaction with open educational resources in a professional communication course
    (2023) Vihos, Jill; Chute, Andrea; Johnston, Sharon; Pawliuk, Brandi; Buro, Karen; Velupillai, Nirudika; Sampaga, Catherine
    Open educational resources (OER) are emerging as reference materials in nursing. The purpose of this study was to explore undergraduate nursing students' experiences with OER and the relationship with demographic variables. Findings from this descriptive survey study reveal that the quality of OER materials and learner experience were highly correlated. Integration scores for the youngest cohort was significantly lower compared to other age groups. The integration of quality OER is correlated with positive student experience.
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    Crossing borders: a narrative inquiry into the experiences of international graduate nursing students
    (2023) Oyelana, Olabisi
    In response to the global needs for nursing faculty, and nurses at leadership and advanced clinical practice roles, aspiring students from different countries come to Canada for their graduate nursing education. The positive reputation and the numerous perceived advantages of the education system are particularly compelling to applicants from many developing countries. However, many international students come from different social, historical, political, cultural, and educational backgrounds that deeply influence their learning experiences in Canada. Working from a space of the inquirer’s personal experience, the aim of this inquiry was to understand the experiences of international graduate nursing students across time, place, and social contexts. The focus was to unravel the two puzzles of this inquiry: What stories across social, historical, political, cultural, and educational borders shaped our identities and ways of knowing? How did our experience in Canada shift our lived stories? Four participants were invited from a Master of Nursing program at a university in Western Canada. Living alongside the participants in a series of conversations for over one year. Multiplicity of borders and identity making, border making, border crossing, and border dwelling were the four sustaining threads that resonated across our narrative accounts. These four threads provided insights into the lived experiences of tensions, the shifting of identities, and the day-to-day challenges that international students face while learning in Canada. Being aware of these experiences and acknowledging them could be a significant stride towards addressing the issues of inequity and exclusion within Canadian graduate nursing education.
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    An evolutionary concept analysis of learner-centered teaching
    (2021) Oyelana, Olabisi; Olson, Joanne; Caine, Vera
    Introduction An increasing need for a paradigm shift from traditional teacher-centered teaching model has led to an adoption of learner-centered teaching (LCT) in nursing education. However, programs aimed at LCT barely integrate its principles within their frame of reference, as there tends to be no explicit or clear operationalized definition. The ambiguity and a lack of consensus not only predisposes nursing faculty to erratic teaching practices but also compromises the validity and trustworthiness of any scholarship associated with LCT. Objective The aim of this review was to clarify the concept of LCT for nursing education research and teaching practice purposes. Design and Methods We used an evolutionary framework to review the literature relevant to LCT. Evolutionary concept analysis is a scientific method of inquiry which focuses on analysis of empirical data to identify the attributes, antecedents, and consequences of a concept. Data Sources A comprehensive and systematic review of empirical and conceptual publications from the disciplines of Nursing, Medicine, and Educational psychology provided the sources for this concept analysis. Results. The key defining attributes of learner-centered teaching identified were autonomy, empowerment, engagement, and collaboration. The key antecedents for LCT were trusting relationship, personal responsibility, mutual respect, and empathy. We identified nine primary consequences and an exemplar of LCT from personal teaching experience and the literature. Conclusions LCT is a highly complex concept with many aspects that make it difficult to provide an authoritative definition. However, we identified key attributes, antecedence, and consequences for an operationalization of LCT in nursing education research and teaching practice.
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    Learner-centred teaching in a non-learner-centred world: an interpretive phenomenological study of the lived experience of clinical nursing faculty
    (2018) Oyelana, Olabisi; Martin, Donna; Scanlan, Judith; Temple, Beverley
    Background With the growing complexities in the contemporary health care system, there is a challenge of preparing nurses for the practice demands. To this end, learner-centred teaching has emerged in many nursing curricula in Canada and evidence indicates its effectiveness in developing the essential practice skills in nursing students. It is important to examine the experience of the clinical faculty members who implement learner-centred teaching, as doing so would provide an insight to the factors that may hinder the implementation of learner-centred teaching in the practice settings. Objective This phenomenological study aimed to address two research questions: what does learner-centred teaching mean to clinical nurse faculty? What is the lived experience of clinical nursing faculty who incorporate learner-centred teaching? Methods Ten clinical nurse faculty members who had at least two years of clinical teaching experience volunteered to participate in the study. Data were collected using a semi-structured interview guide and audio recorder. Additional data sources included a demographic survey and a reflective journal. Results Multiple sub-themes emerged from this study from which three significant themes were consolidated: diversity of meanings, facilitators of LCT, and barriers to LCT. However, an overarching theme of “learner-centred teaching in a non-learner-centred world” was coined from participants' accounts of their experiences of barriers in incorporating LCT in the practice settings. Conclusion A collaborative effort between faculty and the stakeholders is paramount to a successful implementation of learner-centred teaching in practice settings.
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    An evolutionary concept analysis of learner-centered teaching
    (2022) Oyelana, Olabisi; Olson, Joanne; Caine, Vera
    Background An increasing emphasis on a paradigm shift from the traditional teacher-centered approach has led to the adoption of learner-centered teaching in many nursing education programs. However, the lack of consensus regarding the meaning warranted an analysis of learner-centered teaching. Objective The objective of this analysis was to clarify the concept of learner-centered teaching for nursing education and research. Design An evolutionary framework was used to perform a comprehensive review of both theoretical and empirical literature relevant to learner-centered teaching. An evolutionary concept analysis is a method of inquiry used to analyze the literature, with the purpose of identifying the attributes, antecedents, and consequences of a concept. Sample and setting Empirical and theoretical literature selected from the fields of education, nursing, and medicine. Methods A comprehensive review and analysis of theoretical and empirical publications from nursing, medicine and education disciplines provided a rich data source for this concept analysis. Results Four defining attributes of learner-centered teaching were identified: autonomy, empowerment, collaboration, and engagement. Four antecedents, three surrogate terms, eight related concepts, and nine primary consequences of learner-centered teaching were also identified. Exemplar cases of learner-centered teaching emerged from personal teaching practice experience and the empirical literature. Conclusions Learner-centered teaching is a complex concept with many aspects conceptualized or operationalized which make it difficult to authoritatively define the concept. However, the features of learner-centered teaching identified in this analysis offered a good basis for the evaluation, application, and further development of the concept in nursing.
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    A critical look at exclusive breastfeeding in Africa: through the lens of diffusion of innovation theory
    (2021) Oyelana, Olabisi; Kamanzi, Joyce; Richter, Solina
    Background Exclusive breastfeeding is a practice widely promoted across many developing countries. Despite all the potential advantages and three decades of promotional efforts, exclusive breastfeeding remains short of expectations with a consistent low rate of practice in sub-Sahara Africa since its inception. Objectives Roger’s diffusion of innovation theory was used to examine innovation attributes affecting the adoption of exclusive breastfeeding in Africa. Methods A critical review exploring evidence on exclusive breastfeeding in Sub-Sahara Africa was conducted. The databases MEDLINE, CINAHL, Scopus, JSTOR, Google Scholar, and PUBMED were searched and supplemented with additional search of grey literature. Eligible studies were selected and a directed content analysis approach to data extraction was conducted in alignment with the diffusion of innovation theory to facilitate narrative synthesis. Result Articles reviewed were diverse and focused on studies exploring barriers to exclusive breastfeeding in several African countries. Key findings indicate several attributes of exclusive breastfeeding are incompatible with African traditional beliefs and cultural practices. Conclusion The attributes identified in this review are worthy of consideration when promoting exclusive breastfeeding among the African people as these are critical predictors of its adoption. Moreover, the adoption of exclusive breastfeeding requires more of socio-cultural processes rather than technical processes. Extended family members and the grandmothers have significant roles in childcare, and they have a powerful influence on innovation decision-making about exclusive breastfeeding. We recommend that the opinions of these adopters be considered when planning exclusive breastfeeding programs. Exclusive breastfeeding needs to be modified to accommodate African traditional values system.
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    Who will lead nursing into the future?
    (2012) Miller, Kathleen; Cummings, Greta
    Recent research reveals a need for improved leadership capabilities among nurses, from the front-line nurse to those in management capacities. This "op-ed" piece is a discussion arising from the results of a study examining two groups of high school students: one participating in a leadership training program and one not participating. With their responses, these students demonstrated a stereotypical view of the work of nurses and were not interested in pursuing a career in nursing. They also didn't see nursing as a career in which to practise their leadership abilities. We raise questions about our ability to meet the goals of the Canadian Nursing Association as set out in Toward 2020 if we, in the nursing profession, are not successful in attracting students who understand the complexities of nursing practice and have a desire and the ability to help advance the profession in Canada. Recommendations for further research are presented.
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    Indigenous health
    (2023) Foster-Boucher, Caroline
    This book covers the nursing concepts, knowledge, research, and skills that are essential to professional nursing practice in Canada.
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    Client perceptions of healthcare professionals (HCP) who have visible body art: a scoping review
    (2023) Wildeman, Amy; Reisdorfer, Emilene
    Background: In healthcare settings, physical appearance plays a significant role in a patient's first impression of a healthcare professional’s competence, compassion, performance, and quality of care. Given that nurses are an essential part of the patient care team, it is imperative for them and other healthcare providers to recognize what the client’s response might be to their use of personal body art (i.e., tattoos, piercings, and designs using skin as a medium), while still achieving therapeutic relationships with clients. Purpose: This scoping review aims to answer the following question: What is known from the existing literature about the clients' perceptions of healthcare professionals (HCP) who have visible body art, including its possible effects on the patient’s perception of patient care. Methods: Electronic databases of PubMed, Medline, PsycINFO, Web of Science, CINAHL, and Scopus were searched to identify studies published until 2022. They were assessed for quality using the Appraisal tool for Cross-Sectional Studies (AXIS) tool. The following stages were followed: identifying the research question, identifying relevant studies, study selection, charting the data, and collating, summarizing, and reporting the results. A total of 435 studies published until January 2022 were identified, of which 8 met the inclusion criteria. Implications: Out of eight studies included in this review, six identified that body art is negatively associated with patient care, and two found there is no impact on body art and patient perceptions of care. Conclusion: Results show that clients attribute a higher degree of professionalism to HCP without visible body art. Finally, some studies indicate that female HCP with visible tattoos were perceived as being less professional than their male counterparts. It is essential to understand patient perceptions of healthcare professionals with and without body art and determine if appearances can alter the relationship between patient and provider.
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    Alcohol health warning labels: a rapid review with action recommendations
    (2022) Giesbrecht, Norman; Reisdorfer, Emilene; Rios, Isabelle
    A rapid review of research on health warning labels located on alcohol containers (AWLs) was conducted. Using five search engines (Embase, Medline, Pubmed, Scopus, Psyinfo), 2975 nonduplicate citations were identified between the inception date of the search engine and April 2021. Of those, 382 articles were examined and retrieved. We selected 122 research papers for analysis and narrative information extraction, focusing on population foci, study design, and main outcomes. Research included public opinion studies, surveys of post-AWL implementation, on-line and in-person experiments and real-world quasi-experiments. Many studies focused on the effects of the 1989 United States Alcoholic Beverage Labeling Act on perceptions, intentions and behavior. Others focused on Australia, Canada, the United Kingdom, England or Scotland, Italy and France. There was substantial variation in the design of the studies, ranging from small-scale focus groups to on-line surveys with large samples. Over time, evidence has been emerging on label design components, such as large size, combination of text and image, and specific health messaging, that is likely to have some desired impact on knowledge, awareness of risk and even the drinking behavior of those who see the AWLs. This body of evidence provides guidance to policy-makers, and national and regional authorities, and recommendations are offered for discussion and consideration.
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    Stakeholder experiences of a public safety personnel work reintegration program
    (2023) Jones, Chelsea; Spencer, Shaylee; Juby, Brenda; O’Greysik, Elly; Smith-MacDonald, Lorraine; Vincent, Michelle; Brémault-Phillips, Suzette
    Public safety personnel (PSP) are at risk of experiencing operational stress injuries (OSIs). The functional impairments caused by OSIs can contribute to challenges with returning to pre-injury operational requirements. A Canadian municipal policing agency developed a peer-led workplace reintegration program (RP) to assist PSP in their workplace reintegration after an illness or injury. Although this RP has been used internationally, there is a paucity of research on this program and its implementation by PSP organizations. The perspectives of key stakeholders are important for capturing the current state of RPs and future directions for the advocacy, implementation, sustainability, and spread of the RP, and to set the stage for future research. The purpose of this study was to explore the experiences and perspectives of key stakeholders engaged in the creation, implementation, facilitation, and execution of RPs in Alberta, Canada. This will help identify strengths, barriers, facilitators, needs, processes, and attitudes associated with the RPs and direction for future research. A qualitative thematic analysis of focus groups (N=8) involving key stakeholders (N=30) from five PSP organizations with RPs was conducted using a community-engaged research approach as part of a larger mixed-methods study. Four key themes emerged from the participants: (1) Integral elements of success, (2) Integral needs, (3) Key areas of growth, and (4) Evolution of the Program. While RPs are highly regarded by the key stakeholders, it is essential that evidence-based research guide the evaluation, modification, implementation, spread, and scale of RPs globally.
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    “Collapsing into darkness”: an exploratory qualitative thematic analysis of the experience of workplace reintegration among nurses with operational stress injuries
    (2023) Jones, Chelsea; Juby, Brenda; Spencer, Shaylee; Smith-MacDonald, Lorraine; O’Greysik, Elly; Vincent, Michelle; Mooney, Colleen; Bright, Katherine S.
    Background: Nurses are engaged in an unpredictable and dynamic work environment where they are exposed to events that may cause or contribute to physical and/or psychological injuries. Operational stress injury (OSI) may lead to an extended time away from work or nurses leaving the profession altogether. A deliberate focus on the workplace reintegration phase of the mental health recovery process may lead to the increased retention of nurses in their profession. Prior to the creation and implementation of potential solutions to address workplace reintegration, it is imperative to explore the experiences and perceptions of nurses affected by OSI. This qualitative study aims to investigate the experiences and perceptions of nurses (N = 7) employed within a Canadian provincial healthcare system who have attempted workplace reintegration after being off of work with an OSI. Methods: Nurses were recruited via social media, unit emails, and word of mouth. Data were collected through recorded semi-structured interviews conducted over videoconferencing. Once transcribed, the data were thematically analyzed using an inductive approach. Results: The resulting themes included (1) heroes to zeros, (2) changing the status quo, (3) connection is key, and (4) post-traumatic growth: advocacy and altruism. Study participants indicated both that nursing culture and a cumulation of events contributed to a need for a leave of absence from work and that a formalized process was desired by nurses to assist in returning to work. Conclusions: The development, implementation, and exploration of innovative policies, procedures, and initiatives to bridge the gap from clinical interventions to workplace reintegration are needed for nurses experiencing OSI. Further research is also needed regarding mental health impacts and appropriate resources to support nurses in their workplace reintegration process after experiencing psychological and/or physical injury.
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    How do we keep our heads above water? An embedded mixed-methods study exploring implementation of a workplace reintegration program for nurses affected by operational stress injury
    (2023) Jones, Chelsea; O’Greysik, Elly; Juby, Brenda; Spencer, Shaylee; Vincent, Michelle; Smith-MacDonald, Lorraine; Mooney, Colleen; Brémault-Phillips, Suzette
    Background: Nurses are exposed to potentially psychologically traumatic events which can lead to operational stress injuries (OSI). Workplace reintegration after an OSI can be challenging, especially with repeated exposure to potentially traumatic scenarios and workplace demands. A workplace reintegration program (RP) originally developed for police officers may be of benefit for nurses returning to work after an OSI. The purpose of this study is to investigate the perceived need for an RP for nurses, and its potential contextualization and implementation in the nursing context using an implementation science approach. Methods: This mixed-methods study collected data via questionnaires and focus groups from acute care nurses in Canada (N = 19). Data analysis was conducted using descriptive statistics, thematic analysis, and an organizational readiness assessment. Results: Study participants indicated that formalized processes were rarely used to support nurses returning to work after time off due to mental health challenges. Themes included (1) “The Perfect Storm”: the current state of return-to-work, (2) Integral Needs, and (3) A Break in the Clouds: hope for health. Conclusions: Exploration of innovative programs such as the RP may provide additional support to nurses affected by OSIs. Further research is needed regarding workplace reintegration for nurses, and contextualization and evaluation of the RP.
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    How can we keep our patients safe? Managing cyber-threats post-pandemic
    (2023) Neumeier, Melanie
    The COVID-19 pandemic has created unprecedented challenges for the healthcare industry worldwide, including an increase in cyberattacks. Canadian hospitals have been particularly hard hit by ransomware attacks, which have surged during the pandemic. Ransomware attacks can have serious consequences, including the disruption of patient care and compromise of sensitive patient data. There have been several recent ransomware attacks on Canadian hospitals that highlight the seriousness of this threat. Attacks on the University of Ottawa Heart Institute and the Newfoundland and Labrador health system in 2021,Toronto Sick Kids Hospital in December 2022, and Ross Memorial Hospital in February 2023are just some examples of recent cyberattacks on healthcare targets (CBC News, 2021; Mosleh, 2023; Solomon, 2022). And while LockBit apologized for the attack on Toronto SickKids Hospital in December (Mosleh, 2023), the increase in frequency and scope of ransomware attacks on our healthcare system is a national concern. The Communications Security Establishment, the federal government’s IT security agency, has noted that ransomware and other malware attacks are not only becoming more frequent, but are also becoming more sophisticated, and hospitals have some unique factors that make them vulnerable and attractive for cyber criminals (CBC News, 2021).
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    Personal health information at your fingertips: the growing pains and possibilities of a patient portal
    (2022) Neumeier, Melanie
    Healthcare technologies are constantly evolving to facilitate more efficient, effective, and appropriate patient-centered care, and an upcoming integration to EHRs will help make healthcare more inclusive for transgender and gender diverse people.
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    Personal health information at your fingertips: The growing pains and possibilities of a patient portal
    (2022) Neumeier, Melanie
    After running into some health problems over the last few years I have had ample experience with the benefits, and frustrations, of accessing a patient portal. Digital mobile access to my personal health information is something I felt was long overdue, so I was excited to finally have access to the information I needed when I needed it so that I could bean active participant in my own care. I had great expectations for the patient portal system, and as with all great expectations it was difficult for reality to deliver.