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Title: Being there and being with families: Family understandings of public health nurse-family relationships.
Contributors: Deborah-Lee Catherine Collette (author), Martha MacLeod (Thesis advisor), Lela Zimmer (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: As a phenomenon in nursing, the experience of presence is thought to unfold through relationships between nurses and their clients. Although literature on nurse-client relationships emphasizes the importance of presence few studies explore the phenomenon from the perspective of families. In this thesis I explore families' experience of nursing presence in their relationships with public health nurses. The intent is to understand how families experience presence and how nursing presence contributes to the development of relationships. Eight family interview transcripts were analyzed using a hermeneutic phenomenological approach. Analysis and interpretation of the transcripts revealed that families experience nursing presence when they work with nurses whose perceptual abilities and relationship skills enable them to intuit how to respond to and work with families in ways that are meaningful to the family. The study demonstrates the need for nurses to be responsive to families' needs as they shift and change over time. --Leaf ii.
Discipline: Nursing
Date added: 2017-04-11T21:13:00.359Z

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
Date added: 2017-04-10T22:06:08.65Z

Title: "Running to stand still": Nurses' roles with children and families in the community in Scotland. Relationships between policy and practice.
Contributors: Carolyn May Schellenberg (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: No abstract available.
Discipline: Community Health
Date added: 2017-03-29T17:32:40.701Z

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
Date added: 2017-04-10T22:05:16.282Z

Title: Rural acute care nursing in British Columbia and Alberta: An interpretive description of professionalism.
Contributors: Kelly Joan Zibrik (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: Delivery of health care services in rural areas of Canada is challenging due to geographic and economic factors, and persistent problems with recruiting and retaining nurses. Registered Nurses in acute care represent the largest cohort of health care workers in rural Canada, and little is known about their professional experiences. The purpose of this study was to understand how rural acute care nurses in British Columbia and Alberta experience professionalism and professional practice. Eight interview transcripts from a national study entitled, The Nature of Nursing Practice in Rural and Remote Canada were analyzed using an interpretive description method. Analysis and interpretation revealed that rural nurses experience professionalism in the community and workplace contexts. Being visible and embracing reality emerged as central themes in rural nurses' experiences of professionalism. Findings from this study contribute a greater understanding of professionalism in rural nursing, and its relationship to job satisfaction, recruitment, and retention.
Discipline: Nursing
Date added: 2017-03-30T17:04:05.775Z

Title: Clinical encounters in Canada's northern territories: implications for nurse practitioners working with aboriginal women to promote sexual health
Contributors: Michelle R. Wolsky (author), Martha MacLeod (Thesis advisor), Janet Baillies (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: In Canada's northern territories, nurse practitioners (NPs) play a significant role in the delivery of health care and are often the first and only point of contact as primary health care providers for Aboriginal women. As such, NPs are uniquely situated to work with Aboriginal women in northern communities to address the greater health inequities, incidences of communicable and chronic disease in ways that account for locally specific historical, geographic, economic, social, and cultural contexts. However, it is increasingly evident that clinical encounters between NPs and Aboriginal women in the north are not resulting in improved sexual health outcomes. The intent of this review was to explore the factors influencing why sexual health outcomes for Aboriginal women are not improving. A review of Nursing and Aboriginal peoples' health literature revealed that, while broader colonial contexts inform Aboriginal women's health, there are concrete structural and interpersonal factors that most directly impact clinical encounters. These include how health services are delivered to Aboriginal peoples in Canada, the health policies that govern the delivery of health care to Aboriginal women, and NP clinical practice issues in the north. These factors come together to inform how relationships between NPs and Aboriginal women can and does evolve in clinical settings. What is evident from this review is the importance of NPs becoming aware of the historical complexities and post colonial processes that impact Aboriginal women's health. This awareness will allow NPs to work collaboratively with Aboriginal women to address those mechanisms of delivery, policies, and cultural attitudes that can act as barriers for accessing health care. It is through working collaboratively with Aboriginal women to improve clinical encounters that changes in sexual health outcomes will occur. --P. iii.
Discipline: Nursing-Family Nurse Practitioner
Date added: 2017-04-10T22:08:46.266Z

Title: The influence of job and community satisfaction on retention of public health nurses in rural British Columbia.
Contributors: Mary Henderson Betkus (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: The importance of having a motivated workforce in any organization cannot be over-emphasized. One of the factors that contribute to employee motivation is their perception of the organization's reward system. This study examined how employees' perceptions of the reward systems in terms of support for team work and fairness promote cooperation and affect employees' level of satisfaction with the reward system. The study was conducted using a sample of 35 employees of a financial institution in Nigeria, West Africa. Data was collected through a cross-sectional survey using a self-administered and web-based questionnaire. Pearson's correlation was used to analyze the data. The results showed that there was no relationship between an individual-based reward system and employees' pursuit of individual goals instead of team goals, as well as withholding of ideas and information by employees in a team situation. This finding is contrary to earlier studies which had suggested that an individual-based reward system in a team situation can result in employees withholding ideas and information, as well as pursuing individual goals to the detriment of team goals. The results also showed a positive impact of perception of being in team, perception of fairness of a reward system and receipt of feedback on employee satisfaction. The significance of this study is on evaluating how a company can use its reward system to increase motivation, satisfaction and cooperation among team members. It is recommended that a percentage of employees' compensation should be tied to the team's performance, in addition to individual performance. Also feedback should be used as a tool for performance management and not just for performance evaluation. --Leaf ii.
Discipline: Business Administration
Date added: 2017-03-30T16:58:00.336Z

Title: Capacity building: The experience of health education workers in the Yukon.
Contributors: Janet E. Horton (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: No abstract available.
Discipline: Community Health
Date added: 2017-03-30T17:01:12.988Z

Title: Perspectives of urban Aboriginal people with diabetes regarding appropriate health services.
Contributors: Gillian Tyson (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: The purpose of this study was to explore urban Aboriginal people's perspectives on diabetes and their experiences using health services. Using a qualitative approach, in-depth semi-structured interviews were conducted with eight urban Aboriginal people with diabetes. The data generated were analyzed using content analysis. The findings indicate that urban Aboriginal people have difficulty accessing and navigating health care services as result of social, cultural, and economic circumstances. Further, lack of resources and information appropriate to participants' needs created difficulties in their making lifestyle changes for diabetes management. Emphasized was the need for greater diabetes awareness and availability of suitable resources for the Aboriginal community. In the discussion, the new paradigm of chronic disease management, with emphasis on self-management, is explored as an approach to change the health care system and make improvements to diabetes care services that positively contribute to Aboriginal people's health. Based on the results, implications for programs and services, health care providers, and further research are presented.
Discipline: Community Health
Date added: 2017-03-30T16:59:48.244Z

Title: An exploration of the health concepts, peer-helping behaviours and attitudes of street-involved youth
Contributors: Tracy Yvonne Dolan (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: Health concepts, peer-helping behaviours and the role of the peer network in passing health information was explored among street-involved youth in a city in northern British Columbia. Perceptions of 21 youth were gathered through interviews and/or focus group discussions. Data were analyzed using content analysis and were viewed through the lens of the health belief and health promotion models. Results indicate that street-involved youth form peer groups and that these peer groups provide some positive support but also reinforce some unhealthy behaviours. The youth provide one another with some information related to their health and are able to provide guidance as to who would prove to be effective peer health counsellors. Youths' descriptions of what it means to be healthy depict mainly physical states of health and convey that the youth either have not incorporated a broad or holistic sense of health into their health concepts or are simply unable to express it. Exceptions to this limited view of health are among older youth who have had exposure to counselling. The Health Promotion Model was useful in explaining links between the health concept of street involved youth and its implications for the development of effective peer programs. The Health Belief Model was useful in calling attention to some of the perceived barriers to health action that could be minimized through an effective peer program. Implications for further research into factors underlying variations in health concepts and peer-helping behaviour in street-involved youth are discussed.
Discipline: Community Health
Date added: 2017-04-10T22:16:39.202Z

Title: Collaborative nurse practitioner and physician health care service provision for at-risk seniors in Fort St. John, B.C.
Contributors: Diella Schatz (author), Martha MacLeod (Thesis advisor), Lela Zimmer (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: Collaborative nurse practitioner and physician primary health care service provision has the potential to improve access, ensure quality, and promote cost effective primary health care and case management for frail elders. Through a critical appraisal of research, this paper will seek to explore outcomes regarding the provision of collaborative nurse practitioner and physician community based primary health care service for the frail elderly. The research substantiates that collaborative nurse practitioner and physician health care service provision to at-risk seniors reduces emergency department utilization, reduces admissions to hospitals and nursing homes, and maintains or improves functional capacity. Three integrated health care service delivery models will be discussed, critiqued, and woven into these research findings to serve as a framework to sift these research finding into practice. Finally, recommendations based on this research will be proposed for integration into the Northern Health Authority Integrated Health Network for at-risk seniors in Fort St. John, B.C. for application of these research findings in practice..--P.ii.
Discipline: Nursing-Family Nurse Practitioner
Date added: 2017-04-10T22:07:30.965Z

Title: The relationship between hemodialysis patients' fluid compliance and selected socio-demographic factors in Northern Alberta, Canada
Contributors: Shyvi Jacob (author), Martha MacLeod (Thesis advisor), Shannon Freeman (Thesis advisor), University of Northern British Columbia College of Arts, Social, and Health Sciences (Degree granting institution), Erin Wilson (Committee member)
Abstract: Compliance with fluid restrictions is an important factor in the health and well-being of hemodialysis patients. Non-compliance is a common and increasing problem for patients, leading to morbidity and death. This study aimed to investigate the relationship between socio-demographic factors and fluid compliance among hemodialysis patients. This retrospective, cross-sectional, descriptive study included 153 patients, a majority of whom were residing in an urban location, and were receiving dialysis treatment in a metropolitan area in Northern Alberta, Canada. About 42% were fluid non-compliant. Younger and male patients found more likely to be fluid non-compliant. Patients who resided and received care in metropolitan areas, had median income above $35,000, and attended all dialysis sessions were less likely to be fluid non-compliant. Psychological support, continuous educational interventions, and follow-up to remind patients about the importance of complying with their fluid restrictions are recommended to minimize the risk of fluid non-compliance.
Discipline: Nursing
Date added: 2017-05-15T16:21:55.178Z

Title: Addressing quality of worklife: Examining horizontal workplace bullying behaviors in nursing.
Contributors: Sheila Blackstock (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: Background: Research suggests that formal and informal institutional workplace structures and processes can create a fertile environment for bullying. Exploration of key organizational antecedents of role ambiguity, role conflict, role overload, and perceptions of nursing supervisor fairness in relation to horizontal workplace bullying among Registered Nurses (RNs) is missing. Purpose: This study explores relationships between workplace structures, processes, and bullying among RNs, and examines the construct validity of Hutchinson et al.'s (2008) Workplace Bullying Instrument (WBI). Method: A web-based survey was distributed to 477 (N=94) RNs employed at a British Columbia hospital. Data Analysis: Correlations assess relationships among variables of workplace structures, processes, horizontal workplace bullying, and intentions to leave. Results: Workplace bullying among RNs was multidimensional (i.e., comprising individual and organization factors) and bullying experiences can be situated within workplace structures and processes. The construct validity of WBI was confirmed. Implications for future research and workplace policy are discussed. --P. ii.
Discipline: Nursing
Date added: 2017-03-30T17:10:12.159Z

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
Date added: 2017-03-29T17:26:03.539Z

Title: Meaning-making in 'outsider art' as a reflection of stigma and marginalization in mental illness.
Contributors: Madelaine Ross (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: The public engages directly with conceptions of mental illness through the meaning-making process in outsider art. Marginalization is acknowledged in current research as a considerable barrier to recovery from mental illness. The focus of this thesis is the critical visual analysis of meaning-making in outsider art to identify processes and practices which reinforce stigma and marginalization of artists diagnosed as mentally ill. The analysis of meaning-making processes at the sites of production, image and audience provides important insights for contemporary mental health research, policy and practice. Psychiatric/mental health knowledge, practices and research play a significant role in marginalization at the sites of meaning-making and so have considerable potential, authority and responsibility to reduce stigma and marginalization. Changing the process within mental health-arts has potential to reduce marginalization for artists with mental illness, increase inclusion and the reduce stigma of mental illness. --P.ii.
Discipline: Community Health
Date added: 2017-03-30T17:04:47.891Z

Title: The meaning of resettlement: Burmese political refugees in Vancouver
Contributors: Colleen Shirley Jeffery (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: The increasing number of political refugees to Canada has raised questions regarding their resettlement, adaptation, and mental well-being. Nurses and other health care and social service professionals do not know enough about the psychological adaptation of this refugee type. This may result in nurses and other health care and social service professionals planning and providing care that is not relevant to their specific needs, thereby increasing political refugees' risk of adaptation problems and poor mental health. Recognizing that refugee adaptation and mental health is affected by multiple interrelated factors including the way in which one perceives experience, the purpose of this study was to understand the meaning of the resettlement experience from the perspective of Burmese political refugees in Vancouver. Phenomenology, a qualitative research methodology, was used in this study. Data were derived through a series of in-depth interviews with five Burmese refugees and three key informants. Participants shared information of their past and present realities which provided a contextual basis for understanding their experiences. Participant observation data and reflection of the researcher's personal experiences working with Burmese refugees in exile reinforced the formal interview findings and provided a broader context for interpretation. Analysis of interview data reveal an experience that can be conceived of as one of both loss and reconstruction, challenges and opportunities. The participants mourn the loss of their identity, their culture, and the social, economic, and political status that they once commanded. They grieve the loss of family support. Factors such as past traumatic experiences involving violence and persecution, their identity as educated revolutionaries, occupational hardship, language difficulties, and isolation from a well-established ethnic community are seen as important influences on the participants' sense of loss. These factors are, in tum, influenced by international and national policies. While the refugees grieve for the multitudinal losses that their resettlement represents, they also rejoice in the opportunities that living in Canada is giving them. Resettlement to Canada means their future holds some form of hope. Resettlement is viewed as an opportunity to learn, to develop new skills, and, most importantly, to reestablish themselves as revolutionaries who will, one day, return to their homeland. This sense of opportunity provides the refugees with the strength to cope with the stresses of living in a foreign environment and allows them to rationalize the losses of the past. The participants' identity as political refugees is an important variable influencing this sense of opportunity and the larger meaning of resettlement. Understanding these meanings and the factors affecting them have implications for public health policy, nursing practice, research and education.
Discipline: Community Health
Date added: 2017-04-11T21:17:43.291Z

Title: Adolescent girls' experience of parental support within their experience of physical activity.
Contributors: Cheryl Jean Brown (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: No abstract available.
Discipline: Community Health
Date added: 2017-03-30T16:58:08.263Z

Title: Carving out a place: Establishing a new nurse practitioner practice in rural and remote Canada.
Contributors: Donna L. M. Bentham (author), Lela Zimmer (Thesis advisor), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: Across the country, the development of legislation and new employment opportunities are encouraging the implementation of nurse practitioners (NPs) in a variety of acute care and primary care settings. In the literature the roles and practices of NPs are reviewed primarily from the perspective of availability, quality, and accessibility of health care services. The NP is a new health care provider role, practicing independently in rural and remote communities. There is little information on how new NPs enter a community and establish a practice or what sustains them in their practice. There is limited research, particularly in the Canadian health care context from the perspective or NPs themselves. Without the perspective of the experiences of establishing a new NP practice in rural and remote communities, knowledge of appropriate, context specific supports to recruit and retain NPs in rural communities is limited. This thesis is a qualitative interpretive study of the experiences of nurse practitioners as they establish new NP practices in rural and remote communities across Canada. The data for this study is from in-depth interviews conducted with six nurse practitioners for the Nature of Nursing Practice in Rural and Remote Canada Study. Carving out a place for practice was found to be a challenging process that requires time and support in order for the NP to develop a presence in the community. As the first and only NPs in their communities, resources including appropriate policies, administrative and clerical support, and mentorship opportunities are needed to support the development of these new roles and promote job satisfaction and ultimately retention of these much needed health care providers.'
Discipline: Community Health
Date added: 2017-03-30T17:05:34.049Z

Title: The family nurse practitioner role in improving health care for the person over 70 years of age with chronic nonvalvular atrial fibrillation: the exploration of anticoagulation therapy
Contributors: Brenda Eraut (author), Martha MacLeod (Thesis advisor), Davina Banner-Lukaris (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: The purpose of this project was to answer the question: Is the administration of warfarin the best practice for prevention of stroke in the person who is over the age of 70 years, who has nonvalvular atrial fibrillation (NVAF), and who is at high risk for having a stroke? A comprehensive literature review was conducted to help answer the primary research question. The findings of this review demonstrated that the administration of warfarin therapy was the best practice for the prevention of strokes in high-risk populations. The literature presented in this project further identified that although research findings support the use of warfarin therapy as best practice for prevention of strokes in the high-risk population, warfarin therapy was highly underutilized in general practice or has been managed subtherapeutically. Eight factors that may have affected the prescribing practices or suboptimal use of warfarin therapy by the health care practitioners were discussed. The project also explored how nurse practitioners can offer solutions for optimizing warfarin therapy in NVAF patients and concluded with recommendations for how nurse practitioners may help optimize treatment for patients with NVAF. --P.2.
Discipline: Nursing-Family Nurse Practitioner
Date added: 2017-04-10T22:08:24.751Z

Title: Support for Yukon children with special needs during the transition to kindergarten.
Contributors: Heather Alton (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: No abstract available.
Discipline: Community Health
Date added: 2017-03-30T17:00:44.346Z

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