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Nurse practitioner use of a family centered care approach to manage childhood obesity in the primary health care setting
Title
Nurse practitioner use of a family centered care approach to manage childhood obesity in the primary health care setting
Contributors
Colleen Patenaude (author), Martha MacLeod (Thesis advisor), Linda Van Pelt (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract
Childhood obesity rates are rising at an alarming rate. Obesity has a negative impact on health and well being as well as social development. Obese children have a higher incidence of morbidity and mortality. Current clinical practice guidelines recommend practitioners use a family centered approach to managing childhood obesity. The purpose of this project is to examine the use of a family centered care (FCC) approach in managing childhood obesity in the primary health care setting and determine how best to incorporate it into managing childhood obesity in nurse practitioner (NP) practice. The principles of FCC are reviewed. NP use of existing nursing models such as the McGill model of nursing for guidance in incorporating family centered care into practice is examined and discussed. The research obtained during the literature review indicates using a FCC approach to disease management is effective and can be achieved in the primary health care setting. As a result of the findings, a five step approach to assessing and managing childhood obesity is recommended for NPs practicing in the primary health care setting. --Leaf ii.
Discipline
Nursing-Family Nurse Practitioner
The role of nurse practitioners in primary care in optimizing risk stratification for coronary heart disease in Canadian women: an integrative review
Title
The role of nurse practitioners in primary care in optimizing risk stratification for coronary heart disease in Canadian women: an integrative review
Contributors
Parveen Sangha (author), Caroline Sanders (Thesis advisor), Linda Van Pelt (Thesis advisor), Davina Banner-Lukaris (Thesis advisor), University of Northern British Columbia College of Arts, Social, and Health Sciences (Degree granting institution), Natasha Prodan-Bhalla (Committee member)
Abstract
Coronary heart disease (CHD) is the most common cause of morbidity and mortality in Canadian women. Despite advances in screening and research, CHD continues to pose a significant health care burden to Canadian women. This integrative literature review explores how a Nurse Practitioner (NP) in primary care can optimize risk stratification for CHD in Canadian women. A systematic search of the contemporary literature identified 11 key articles. These were analyzed using the Critical Appraisal Skills Programme tools to assess relevance and the strengths and weaknesses of the evidence. Three key themes emerged from the literature and are explored in detail: the limitations of current risk prediction models for risk stratification in women; the emergence and evolving importance of female-specific risk factors; and additional adjunctive testing (coronary artery calcium screening) that may improve the accuracy of risk prediction models in women. ...
Discipline
Nursing-Family Nurse Practitioner
Nurse practitioner use of patient-centered care to improve the quality of life of women experiencing vasomotor symptoms of menopause
Title
Nurse practitioner use of patient-centered care to improve the quality of life of women experiencing vasomotor symptoms of menopause
Contributors
Shannon Campbell (author), Lela Zimmer (Thesis advisor), Linda Van Pelt (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract
Menopause is a passage in every woman's life. Hormonal changes are responsible for the cessation of ovulation, and this transition can be difficult for some women. Vasomotor symptoms (VMS), consisting of hot flashes/flushes and night sweats, can be bothersome for some, and VMS are the primary reason for women to seek medical attention during menopause. Patient-centered care (PCC) is an approach which improves discussion, promotes patient involvement, and creates a positive provider/patient relationship with a result of improved quality of life (QOL). Hormone therapy, the gold standard for VMS relief, has come under scrutiny in recent years due to a fear of increased health risks with its use. Complementary and alternative medicines are being promoted as natural alternatives. Women are seeking help to make sense of the variety of treatment options available for VMS relief and nurse practitioners are in an optimal position to help these women. Through the use of PCC, nurse practitioners (NP) can conduct a thorough health history and assessment. They can provide expert advice, hold discussions with women about their preferences and assess them for individual risks with the ultimate provision of appropriate and individualized care for women experiencing VMS of menopause. --P. ii.
Discipline
Nursing-Family Nurse Practitioner
Shared decision making in primary care: barriers and facilitators of shared decision making in the context of decreasing the use of unnecessary antibiotics for preschool children ages 3-5 with upper respiratory tract infections
Title
Shared decision making in primary care: barriers and facilitators of shared decision making in the context of decreasing the use of unnecessary antibiotics for preschool children ages 3-5 with upper respiratory tract infections
Contributors
Danielle Raiser (author), Linda Van Pelt (Thesis advisor), Janet Bailles (Thesis advisor), University of Northern British Columbia College of Arts, Social, and Health Sciences (Degree granting institution), Chantel Canessa (Committee member)
Abstract
The unnecessary use of antibiotics for upper respiratory infections is a global public health concern (Alumran, Hou & Hurst, 2013; Lucas et al., 2015; Dwibedi et al., 2015; Kutty, 2011; Llor & Bjerrum, 2014; Rouusounides et al., 2011). This issue is most prevalent in preschool aged children, due to the frequency of upper respiratory tract infections in this group (Alumran, Hou, & Hurst, 2013; Clavenna & Bonati, 2011; Vodicka, et al., 2013). An integrative review was done and ten articles were chosen to answer the question: What are the barriers and facilitators to implementing shared decision making in relation to unnecessary antibiotic use in primary care settings when primary care providers are working with parents of preschool aged children with upper respiratory infections? Barrier subthemes identified were ineffective communication and lack of parental knowledge...
Discipline
Nursing-Family Nurse Practitioner
Primary care management of childhood asthma: addressing caregiver quality of life using asthma action plans with preschool-aged children
Title
Primary care management of childhood asthma: addressing caregiver quality of life using asthma action plans with preschool-aged children
Contributors
Megan Ireland (author), Linda Van Pelt (Thesis advisor), Amy Klepetar (Thesis advisor), University of Northern British Columbia College of Arts, Social, and Health Sciences (Degree granting institution), Chantel Canessa (Committee member)
Abstract
As the leading chronic disease in children both worldwide and in Canada, the care and management of paediatric asthma requires a significant amount of attention within health care delivery and research. While these efforts have typically been directed at the affected children themselves, or at improving the economic burden of this disease, there is substantial literature describing the effects childhood asthma can have on caregivers and their overall quality of life (QOL). Because of the high level of caregiver dependency among young children, such as preschoolers, it is clear that this effect is amplified with asthma in this age group. Current guidelines stress the use of asthma action plans (AAPs) to improve asthma outcomes in children, however there are few studies describing whether these tools may effect caregiver QOL... .
Discipline
Nursing-Family Nurse Practitioner
Screening for androgen deprivation therapy related side effects in men with prostate cancer
Title
Screening for androgen deprivation therapy related side effects in men with prostate cancer
Contributors
Virginia Davis (author), Linda Van Pelt (Thesis advisor), Janet Baillies (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract
Androgen deprivation therapy (ADT) is a common method of treatment for prostate cancer. There are a variety of side effects associated with its use that can negatively impact health and quality of life, yet a significant gap exists in the literature around comprehensive screening recommendations. As a result, this project seeks to answer the question: For Nurse Practitioners (NPs) practicing in a primary care setting, what screening is required to identify side effects in men with prostate cancer receiving ADT? Eligibility criteria for this literature review included data related to ADT and men with prostate cancer, with no limitation to age or stage of disease. The majority of the participants in the primary studies included at least one study group receiving ADT in the primary care setting. This review presented findings based on the physical, cognitive and psychological side effects of ADT, followed by a description of clinical practice guidelines, clinical reviews and editorials in order to highlight the gaps in screening recommendations. Through this process, recommendations for the screening of each individual side effect were developed. It was determined that patients should undergo follow-up within 3 months of ADT initiation, followed by every 3-6 months. Limitations of this project include a scarcity of studies on specific side effects. Implications for practice include patient and primary care provider (PCP) education as well as the development of comprehensive guidelines. Moreover, further research is required for newly defined side effects. It is through appropriate careening that ADT related side effects are identified and treated, thus limited their impact on health and quality of life. --Leaf 2.
Discipline
Nursing-Family Nurse Practitioner
Reducing barriers to accessing primary care for individuals with severe mental illness: examining characteristics of Canadian nurse practitioner practice
Title
Reducing barriers to accessing primary care for individuals with severe mental illness: examining characteristics of Canadian nurse practitioner practice
Contributors
Damen DeLeenheer (author), Martha MacLeod (Thesis advisor), Linda Van Pelt (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract
Individuals with severe mental illness experience reduced access to appropriate and timely primary care. This reduced access has been linked to various barriers and may negatively affect health outcomes. The purpose of this project is to identify the characteristics of nurse practitioner (NP) practice that may reduce the most common barriers to accessing primary care encountered by individuals with severe mental illness. (SMI). The most common barriers to access can be broadly described by three themes and include suboptimal therapeutic relationships, complex service delivery, and stigma. A systematic review of the literature indicated that NPs possess a number of practice characteristics that help overcome barriers to accessing primary care. These characteristics can be described as collaborative practice, a holistic approach, and flexible practice formats. NP practice characteristics have the potential to reduce barriers to care for individuals with SMI and improve access to primary care. --Leaf ii.
Discipline
Nursing-Family Nurse Practitioner
Adherence to physical activity for adults with depression: the role of the nurse practitioner - an integrative literature review
Title
Adherence to physical activity for adults with depression: the role of the nurse practitioner - an integrative literature review
Contributors
Mary M. Hogan (author), Davina Banner-Lukaris (Thesis advisor), Linda Van Pelt (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract
Depression is a significant problem for Canadians, as is the declining overall health of adults due to sedentary lifestyles. The purpose of this integrative literature review is to examine how nurse practitioners, providing primary health care in Canada, can facilitate adherence to physical activity for adults with mild to moderate depression. Background knowledge of depression, physical activity and adherence is presented along with an overview of primary health care. A Medline search collected 15 research articles for analysis. Key findings included reduced adherence to exercise for adults with depression, positive effects on mood from moderate intensity exercise, health promotion challenges within primary care, and interdisciplinary approaches to improving adherence. Recommendations are presented using the 5 A's approach and include the application of psychological theories, assessment of readiness for exercise, individualized exercise prescription targeting public health guidelines, enlisting social supports, frequent follow-up, along with additional education to practitioners. --Leaf ii.
Discipline
Nursing-Family Nurse Practitioner
Effectiveness of physical activity interventions in primary care settings: an integrative litterature review
Title
Effectiveness of physical activity interventions in primary care settings: an integrative litterature review
Contributors
George Wood (author), Linda Van Pelt (Thesis advisor), Jennifer Beaveridge (Thesis advisor), University of Northern British Columbia College of Arts, Social, and Health Sciences (Degree granting institution), Barbara Nielsen (Committee member)
Abstract
Physical inactivity and sedentary lifestyle is a significant problem affecting the overall health of Canadian adults, causing a substantial financial burden on healthcare. Primary care settings are an important component of a multifaceted approach to address this problem. Physical activity (PA) health benefits to improve population health are substantial, but initiating PA health promotion in primary care settings remains a challenge. Primary care providers need effective PA intervention clinical tools to succeed in fulfilling a key role in promoting PA. This integrative literature review explores extant evidence related to PA interventions’ effectiveness. Background knowledge of primary care, health promotion, and PA interventions’ content is presented along with an overview of relevant information on PA. A comprehensive search revealed 13 research articles for analysis. Key findings include evidence on the effectiveness of PA interventions and their components, as well as on the patients and providers’ characteristics associated with increased efficacy. ...
Discipline
Nursing-Family Nurse Practitioner
Transition of care from acute psychiatric care to primary care
Title
Transition of care from acute psychiatric care to primary care
Contributors
Cheryl Dussault (author), Martha MacLeod (Thesis advisor), Linda Van Pelt (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract
For adults with severe mental illness there are serious issues with poor transitions of care. There are many types of transitions that patients experience that can negatively affect continuity of care. These transitions can also compound a patient's illness. The focus within the limits of this project is on care setting transitions from acute to primary care. The point of discharge from acute psychiatric care to primary care is a critical time in the care continuum, and it should be treated with the utmost importance. The purpose of this integrative review is to examine evidence based practices and processes in order to identify ways to facilitate seamless transitions and continuity of care for mentally ill adults discharged from acute psychiatric care to primary care. Further, to offer recommendations for Family Nurse Practitioners practicing in primary care in Canada. Background information on severe mental illness, care transitions, and a case example are presented along with an overview of primary care. A comprehensive search strategy identified 17 relevant studies. Four key findings underline the importance of confidentiality, linkage between acute and primary care, communication, and therapeutic relationships. The recommendations offered are directed to the FNP in primary care, but are relevant to many healthcare providers. They may also be helpful in other settings, such as acute psychiatric care or community mental health. --Leaf ii.
Discipline
Nursing-Family Nurse Practitioner
The role of the nurse practitioner in the implementation of group prenatal visits for aboriginal women: exploring a new type of care
Title
The role of the nurse practitioner in the implementation of group prenatal visits for aboriginal women: exploring a new type of care
Contributors
Rona Loewen (author), Lela Zimmer (Thesis advisor), Linda Van Pelt (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract
Nurse practitioners in British Columbia have an opportunity to introduce an innovative model of prenatal care for Aboriginal women. BC Aboriginal women are at greater risk for pregnancy complications than non-Aboriginal women are. Prenatal care has traditionally offered standardized individual visits for every pregnant woman, regardless of their needs, preferences, or culture. Nurse practitioner (NP)-facilitated group prenatal visits (GPVs) have the potential to provide culturally relevant and accessible prenatal care. An integrative review of the literature demonstrates that by using the Centering Pregnancy model of group prenatal care, NPs can provide relevant, holistic, and safe GPVs. Group prenatal visits can improve the experience of prenatal care for Aboriginal women in British Columbia. Further research is recommended to explore the outcomes of NP-facilitated GPVs and define culturally relevant and safe prenatal care according to BC Aboriginal women. --P. 2.
Discipline
Nursing-Family Nurse Practitioner