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Title: The lived experience of sensing the presence of the deceased
Contributors: Barbara Lynn McLean (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: A common experience among mourners is thinking they have seen, heard, or experienced the presence of the deceased. In counselling literature these experiences are characterized as hallucinations that occur as a symptom of grief. Mourners often believe they are in contact with another reality and as a result feel that mental health professionals misunderstand them, leading to a silencing of the phenomena. In order to be more helpful to these prospective clients, counsellors need a deeper understanding of the experiences from the perspectives of those having them. The purpose of this descriptive phenomenological thesis is to portray the lived experience of perceiving the presence of the deceased as described by seven participants having had the experience. The interview data were transcribed and analyzed for common themes through a process adapted from Colaizzi (1978). Although much was discovered, the most fundamental findings were that the experiences were best described as spiritual and had positive effects on the participants. Other findings included the inability of participants to find words that could describe their experiences, the limited willingness to share their experiences with others, the inability of the participants to control their experiences, and the discovery that participants were not always grieving when the experiences occurred. These findings raise important questions concerning counsellors' approaches to clients. Knowing how to encourage disclosure of the experience, or how cultural differences affect the experiences, or the extent of effects that these experiences have on peoples' lives could be particularly beneficial to counsellors.
Discipline: Education-Counselling
Date added: 2017-04-10T22:15:03.611Z

Title: Reclaiming overall well-being: an analysis of individual- and community-level characteristics contributing to well-being in Yukon First Nations
Contributors: Wilhelmina Stappers (author), Jos~e Lavoie (Thesis advisor), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: This collaborative study implemented a new conceptual framework for health research relevant to Yukon First Nations people and actively involved Yukon First Nations as partners into all steps of the research. Selected characteristics from the Yukon Adult RHS data-set (individual-level characteristics) and the ecological variable survey (community-level characteristics) underwent a sequence of bivariate and multivariate comparisons to explore associations with three outcome measures for overall well-being: no depression, no suicidal thoughts and no suicide attempts. Six individual-level characteristics were identified that had a significant association with the outcome measures: traditional foods modern and traditional health care emotional supports and loving relationships spirituality physical well-being and socio-economic characteristics. The following community-level characteristics emerged as being significantly associated with the outcome measures: geographic characteristics community control community engagement and cultural continuity. Limitations of the study, implications for practice and policy and recommendations for future research and summary comments are identified and discussed.
Discipline: Community Health
Date added: 2017-04-10T22:13:20.914Z

Title: Perceived barriers and meanings: The experiences of people accessing northern mental health services.
Contributors: Jennifer Herman (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: No abstract available.
Discipline: Community Health
Date added: 2017-03-30T17:01:17.234Z

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: 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: What constitutes a good death?: implications for family nurse practitioners in rural British Columbia
Contributors: Cindy Allison Fehr (author), Martha MacLeod (Thesis advisor), Khaldoun Aldiabat (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: Death in an inevitable part of each individual's life. It is how that final event occurs and the time prior to and during one's last phase of life that greatly influence the dying experience for everyone involved. This project aimed to methodically and critically review research evidence to identify key elements necessary for a good death from patients' perspectives. The final number of articles totaled 35, with a dimensional analysis technique used to review and theme data. A key message following data analysis was that there is a diversity of perspectives and subjective characterizations of what constitutes a good death within and across sociocultural groups. Contributions to a good death involved four overarching domains: 1) preparation for death, 2) sources of support, 3) communication, 4) quality of life issues. The rural family nurse practitioner (FNP) role in supporting a good death needs to be based on working to full scope engaging in end-of-life (EOL) care planning and anticipating life expectancy providing holistic and consistent care engaging in multidisciplinary collaboration and effective communication providing caregiver support and education engaging in continuing competence and providing leadership to ensure the best EOL care is available for all patients wishing to remain in their rural home community to die. --Leaf ii.
Discipline: Nursing-Family Nurse Practitioner
Date added: 2017-04-10T22:08:45.114Z

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: Addressing chlamydia in middle aged and older women in rural and northern British Columbia
Contributors: Leona Christine Smith (author), Martha MacLeod (Thesis advisor), Kathy Banks (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: The purpose of this literature review is to identify the ways in which nurse practitioners working in primary care can incorporate sexually transmitted infection (STI) screening as part of the well woman examination, especially among middle-aged and older women and Aboriginal women, in order to prevent long-term complications of undiagnosed STIs, such as pelvic inflammatory disease (PID) and an increased risk of acquiring HIV. An integrative literature review revealed that there is an abundance of research about STI screening for women under the age of 25. However, there is limited research about STI screening, prevention, and treatment among sexually active middle-aged and older women. Primary care providers can conduct screening and prevention practices for chlamydia and other STIs by normalizing STI screening with a nonjudgmental attitude. All primary care providers need further education about the increasing rates of chlamydia and other STIs in middle-aged and older women. --Leaf ii.
Discipline: Nursing-Family Nurse Practitioner
Date added: 2017-03-29T17:25:24.004Z

Title: Role of nurse practitioner in addressing aboriginal diabetes prevention
Contributors: Douglas Andrew King (author), Martha MacLeod (Thesis advisor), Denise Tarlier (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: The current epidemic of Type-2 diabetes among Aboriginal Peoples in Canada has been associated with the poor socioeconomic status of Aboriginal Peoples. Most strategies in diabetes prevention treat health behaviour as an individual choice and ignore how the social determinants of health shape people's health behaviour. The purpose of this project is to explore how NPs might more effectively approach diabetes prevention in Aboriginal communities. This integrative literature review includes a critical analysis of Aboriginal community-based diabetes prevention strategies. A synthesis of their shared characteristics shows that effective community-based diabetes prevention strategies are congruent with primary health care and social justice perspectives on health, which focus on empowering communities and correcting institutionalized discrimination. Community-based strategies empower communities to take control of health promotion efforts and improve community resources and infrastructures that support healthier lifestyles. With an understanding of community-based programs, NPs can begin identifying how primary health care and social justice perspectives can strengthen existing diabetes prevention efforts in Aboriginal communities. --P. i.
Discipline: Nursing-Family Nurse Practitioner
Date added: 2017-04-10T22:05:48.767Z

Title: The teenager's experience of the transition to fatherhood: a community health perspective
Contributors: Joanna Margaret Mackenzie (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: In northern British Columbia, teenage pregnancy rates are high in comparison to other regions in the province. Approximately half of the babies born to teenage women are fathered by teenage men. Despite the attention given to teenage pregnancy by health care providers and policy makers, most of the attention is focused on the mother and her baby. Young fathers' experiences during transition to parenthood have been less well documented than those of mothers. The purpose of this descriptive, qualitative study was to gain insight into the experience of the transition to fatherhood from the perspective of teenage men. The goal of such research was to provide an understanding of those complex issues that are a part of this experience and their impact on the well-being of teenage fathers. In-depth interviews were conducted in a small northern British Columbian community with seven fathers, whose babies were born when they were age 17-19 years. The interviews were transcribed and analyzed using a process of thematic analysis. The latter revealed that the experience of coping with the impact of challenges of fatherhood can be depicted by the metaphor "catching the curve-ball thrown into life". In general, the fathers reported that they have caught "the ball" pretty well. All have adapted to the father role by discarding past destructive behaviors, and through a new motivation to work hard have begun to provide for their families. In spite of obstacles, most have developed a vision of the future, a definite life-direction and close relationships with their children. In terms of personal development, results indicated that the fathers experienced an increase in self knowledge and respect, and improved skills in coping with anger, loneliness and lack of intimacy. As a result of catching the curve-ball, they discovered new capabilities as fathers and providers. Parents and friends were recognized for the key support that they provided, and their on-going affirmation of these fathers in their new roles as parents was seen as vital to the success of early fathering. It is the willingness of these fathers to be responsible parents and remain involved in their children's lives, often against great odds, that needs to be captured and mobilized by policymakers and health care planners. Support services could be. designed to capitalize on those positive attributes of young fathers, as well as responding to direct needs. In addition, policies and educational resources could incorporate positive images that affirm the importance of teenage men in the lives of their children. In the light of some unique findings of this study that relate to the social context of a remote northern community, it is important to produce programs and policies that reflect cultural and environmental differences.
Discipline: Community Health
Date added: 2017-04-11T21:18:38.495Z

Title: The risk handling behaviour of white water kayakers.
Contributors: Sally Lynne Rigoni (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: No abstract available.
Discipline: Community Health
Date added: 2017-03-29T17:32:43.144Z

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: Incorporating health literacy into family nurse practitioner practice: an integrative literature review
Contributors: Francesca Chiste (author), Martha MacLeod (Thesis advisor), Erin Wilson (Thesis advisor), University of Northern British Columbia (Degree granting institution)
Abstract: In Canada, primary health care (PHC) has been endorsed by numerous reports and health care researchers as a mechanism for improving the health and well-being of all Canadians. The family nurse practitioner (FNP) plays an important role in the provision of PHC in Canada. As relatively new providers of primary health care, FNPs have struggled to demonstrate how their patient-centred focus can contribute to positive patient outcomes. The Canadian Nurses Association describes competencies that ensure that FNPs employ a patient-centred focus, but missing is a conceptualization of a framework that offers up a way for FNPs to describe and measure those competencies that allow them to practice in a way that is patient-centred. The concept of health literacy offers a means to address this gap. An integrative literature review was conducted to examine how FNPs can incorporate health literacy into their practice in order to demonstrate their patient-centred competencies and thereby make an impact on patient outcomes. The review of the literature revealed that working from a framework of health literacy promotion offers opportunities to describe and better provide the value-added, public health component of FNP practice, how this component relates to patient-centredness, and how by implying the framework, FNPs can impact patient outcomes. While there is not yet consensus within the literature as to what health literacy frameworks and strategies are most applicable to practice, this in itself presents important opportunities for FNPs to contribute to an emerging body of knowledge. --Leaf ii.
Discipline: Nursing-Family Nurse Practitioner
Date added: 2017-04-10T22:09:06.359Z

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: 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: 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: 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

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

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