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- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Title
- Women's lived experiences of engaging in creative expression within the context of significant life events.
- Contributors
- Marion Joan Healey-Ogden (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
- Abstract
- No abstract available.
- Discipline
- Education-Counselling
- Title
- Anticoagulant versus antiplatelet therapy for acute ischemic stroke
- Contributors
- Tracey L. Rutledge (author), Martha MacLeod (Thesis advisor), Amy Klepetar (Thesis advisor), University of Northern British Columbia (Degree granting institution)
- Abstract
- Acute ischaemic stroke is a leading cause of death in Canada and should be a priority in health care. This paper defines acute ischaemic stroke and provides current statistics, economic costs, risk factors, treatments, and management options. A gap between current practice and literature is identified. Specific treatments of anticoagulant and antiplatelet therapy are explored through systematic reviews, clinical trials, and national guidelines. Considerable consistency in research findings have led to evidenced-based guidelines. Implications for practice, including barriers and facilitators to incorporating evidence-based recommendations are identified. The study concludes with an identification of current provincial guidelines that will provide best patient care in treating patients with acute ischaemic stroke.
- Discipline
- Nursing-Family Nurse Practitioner
- Title
- The nature of public health nursing practice: Finding coherence in complexity.
- Contributors
- Catherine Helena Ulrich (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
- Abstract
- No abstract available.
- Discipline
- Community Health
- 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
- Title
- Seeking a balance: Women's experiences as mothers of young adolescents.
- Contributors
- Carol Gaye Harrison (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
- Abstract
- No abstract available.
- Discipline
- Community Health
- Title
- What factors influence the practice of community-based participatory health research in the Canadian Arctic?
- Contributors
- Joanne (Jody) E. Butler Walker (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
- Abstract
- The literature about community-based participatory research for health offers an approach to investigating health issues that involves community members, practitioners and researchers as equal partners and co-investigators, on issues of importance to the community. There are currently few examples of how to develop and implement community-based participatory research (CBPR) projects in the Canadian Arctic. The study investigates the practice of CBPR in a project that took place in the Kitikmeot Region of Canada's central Arctic. --P.ii.
- Discipline
- Community Health
- Title
- Anemia management protocols in the care of hemodialysis patients: Examining patient outcomes.
- Contributors
- Sushila Saunders (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
- Abstract
- The role of hemodialysis nurses in renal anemia management has evolved through the implementation of nurse-driven protocols. Using the Nursing Role Effectiveness Model, this case control study examined a nurse-driven renal anemia management protocol approach in contrast to a physician-driven approach to assess patient outcomes and costs of renal anemia management from two comparable hemodialysis centres. Both protocol and control groups achieved target hemoglobin levels between 110-120 g/L. In the protocol group, 75% of patients reached TSAT>20% versus 25% in the control group. Iron costs were $17,000 higher in the control group over the study period. The protocol group used more epoetin alfa, trending upwards to approximately 10,000 units per person by the end of the study with over $8 000 per person higher costs compared to the control group. Evaluation of standardized dosing in renal anemia treatment is suggested for patients with diabetes or cardiac co-morbidities. --P.ii.
- Discipline
- Nursing
- Title
- Framing community food security: Connecting the personal to the political.
- Contributors
- Joanne Kathryn Houghton (author), Martha MacLeod (Thesis advisor), University of Northern British Columbia (Degree granting institution)
- Abstract
- No abstract available.
- Discipline
- Community Health
- 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
- 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