1,720,992 research outputs found
Describing of issues within long-term care during the covid-19 pandemic: inappropriate antipsychotic use in persons with dementia and future strategies to improve pandemic protocols
Full text linkDuring the COVID-19 pandemic, long-term care (LTC) homes in Ontario were left severely underprepared, and many residents, specifically those with behavioral and psychological symptoms of dementia (BPSD), were contained and sedated using antipsychotics as chemical restraints. LTC homes were understaffed, crowded, did not have proper infection control protocols and overall lacked funding: all of which left them underprepared when faced with the COVID-19 pandemic. These issues became massive problems that led to many resident deaths during COVID-19. Though recommendations were given to help improve the above weaknesses in LTC after the severe acute respiratory syndrome (SARS) outbreak of 2002-2004, they were not applied to the LTC sector. This paper will recommend future strategies for Ontario's LTC by analyzing past recommendations and changes made in other countries that saw fewer resident deaths during the COVID-19 pandemic. Specifically, implementing quality improvement (QI) projects to improve weaknesses and test changes on a small scale to measure improvements, and implement policy changes to staffing, crowding, funding, training, and types of therapies given to those with dementia in LTC homes to better pandemic preparedness and decrease the use of antipsychotics as chemical restraints.University of Ontario Institute of Technolog
Optimizing the role of the dermatology nurse
Full text linkAccording to the 2012 CSPA, wait times for dermatology care in Canada are becoming worse. Healthcare professionals other than Dermatologists can provide care. The purpose of this study is to understand how the dermatology nursing role can be optimized in Canada. An on-line survey of dermatology nurses and Dermatologists was completed to assess current and desired nurse activities. Barriers and views on enhancing the role of the nurse were explored. Results overall found that dermatology nurses in Canada are working at competent to proficient levels in most activities however wish for increased education and desire to be working at more proficient levels. Dermatologists had differing past experiences with nurses however desired for them to be working at expert levels in most activities. Areas for optimization were with teledermatology, having nurse-led clinics, prescribing, wound care, Moh’s surgery, and skin cancer screening. Recommendations for practice, education and, research are discussed.University of Ontario Institute of Technolog
State of the health system: an exploration of the patients first act and recent outcomes
Full text linkThere is evidence that integrated healthcare systems are considered a solution to the challenge of maintaining access and integrity in healthcare. This is important to uphold the Canada Health Act (1982) principles of universality and accessibility. Furthermore, strong primary care services are the foundation for a high-performing healthcare system and Ontario has focused on improving primary care delivery for many years, through various means. Bill 41, the Patients First Act, was recently legislated in 2016 to promote the integration of primary care services in Ontario, as well as home care and public health, all under the mandate of the Local Health Integration Networks (LHINs). In order to transform and improve our healthcare system, we must reflect on past outcomes of healthcare reform that led to the enactment of Bill 41. It is also important to understand the consequences of any legislation and policy direction in healthcare, as well as its effect on all key stakeholders, including healthcare professionals, patients, services and institutions. Without adequate buy-in and support for new policies, change management will be tumultuous and limit the improvements that are intended to enhance service accessibility for patients. This Major Research Paper will explore the proposed benefits and actual challenges of adopting Bill 41. Furthermore, the paper presents a historical review of primary care reforms; a critical analysis of policy implementation challenges; and discussion of controversial responses to new healthcare legislation in the media, with specific consideration for the recent shift in government power
Understanding the usage of mental health apps among post-secondary students
Full text linkUniversity is a period where adolescents are exposed to novel stressors such as extensive academic overwork, familial pressure, financial concerns, and substantial studying, which can lead to psychological disorders such as anxiety and depression. It is well documented that ethnic and racial students experience a high prevalence of mental disorders yet underutilize health services. Culturally relevant mental health apps that incorporate insights from the targeted population can possibly reduce the mental health disparities that exist among marginalized groups. The study uses a semi-structured interview to explore the experiences of three female Sri Lankan students with mental health apps. The main themes that emerged from the study results included: perceived severity of mental illness; cues to action using the mental health app; self-efficacy and coping strategies; barriers to using mental health apps; benefits of using mental health apps; and recommendations for improving the engagement of mental health apps.University of Ontario Institute of Technolog
Effects of combined aerobic and resistance exercise on quality of life and fitness of individuals who are post cancer treatment: A pilot study
Full text linkCancer Survivors are defined as any individual who has been diagnosed
with cancer and completed treatment, who may or may not be free of the disease
(Speck et al., 2010). Cancer survivors can experience numerous, debilitating and
long lasting side effects. These side effects can occur during and following
cancer treatment and can affect individuals’ daily life. An overview of the
literature on the outcomes that can be experienced from physical activity/exercise
for cancer survivors will be presented.
This study evaluated an 8-week individualized combined aerobic and
resistance training program on individuals post cancer treatment, through
supervised bi-weekly exercise sessions. This study was constructed based on
the review of the benefits of exercise for treatment of cancer and the side effects.
The outcomes of the exercise intervention were evaluated through pre-, post and
three-month follow-up assessments consisting of physical and psychological
testing. Trends of improvements in muscular strength, endurance, reduction in
fatigue levels and perceived Quality of Life (QOL) were identified. These
outcomes further support current literature that, a comprehensive physical fitness
program is important for this population in assisting them with reduction in their
cancer related side effects.University of Ontario Institute of Technolog
Is Yang style Tai Chi a “one size fits all” fall prevention exercise program for older adults?
Full text linkFalls among Canadian older adults is a growing problem, not only in terms of incident rates and its impacts, but most importantly, the vast scope of preventable morbidity and mortality. A decline in age-related physical function is acknowledged as a risk factor of falls. Community-based group exercise programs such as Yang style tai chi may help to reduce fall risk by improving components of physical function. To investigate, a pretest-posttest experimental design was conducted. Post-intervention assessments revealed Yang style tai chi practiced three times a week over eight weeks improved balance, muscle strength and muscle endurance. These findings suggest Yang style tai chi is moderately effective in reducing fall risk but further research is needed to determine the true effectiveness of tai chi as a fall prevention strategy. This study provides directions for future research guided by a proposed conceptual framework and offers some tentative recommendations for community health practice.University of Ontario Institute of Technolog
The role of nurse navigators indiagnostic phase of adult patients with lung cancer
Full text linkCancer is a major concern in today’s health care field, especially in Canadian adults. The diagnostic phase is a clinical process that involves mapping the patient journey, identifying and prioritizing the symptoms, and corresponding the symptoms with relevant treatment. Oncology nurse navigators are professional nurses who educate and advocate for, and navigate the cancer patient throughout his/her entire cancer treatment. Although nurse navigation is recognized by many provinces as a key element of an integrated system of cancer care, it is not yet delivered in a standardized way across Canada. The significance of this study is that it will contribute to evidence that if a connection is found between positive patient experience and the role of nurse navigators, this will allow for a more standardized delivery of nurse navigator programs across Canada. The phenomenological study of the role of oncology nurse navigators within the diagnostic phase was undertaken to understand the impact it had on patient experience, particularly lung cancer patients. Carried out in one of Ontario’s largest cancer centres, Durham Regional Cancer Centre (DRCC) at Lakeridge Health, this study involved interviewing four patients and a focus group with four nurse navigators who were employed at DRCC. A newly designed Bi-Dimensional Framework (Fillion et al., 2012), which focuses on continuity of care and patient empowerment, was used to guide conceptualization of the study, data analysis, and interpretation of results. Through the use of thematic analysis, transcripts were analyzed. The resulting interpretation of the role of the nurse navigators on patient experience is that of patient-focused cancer care; conduct needs assessment, care planning, shared decision-making; easily accessible, identify and eliminate barriers; patient advocate, educational support; personalized symptom management education; and resource navigation. Together these themes identify core areas of practice which can be used as a foundation to develop and maintain the skills to practice in the oncology field, in order to develop the nurse navigator’s role to its full potential.University of Ontario Institute of Technolog
Substance use disorder education for emergency registered nurses
Full text linkPatients with substance use disorders (SUD) constitute up to 1 in 11 emergency department (ED) visits in North America and this number increasing throughout the COVID-19 pandemic (Morin et al., 2017). The ED presents an excellent opportunity to intervene and improve care for patients with SUDs, however there is currently no required or expected level of competency in managing SUDs for registered nurses (RNs) working in an emergency setting. To inform an educational intervention for improving nursing care for patients with SUDs, this project aimed to leverage nursing leadership opportunities to understand the current competency and confidence amongst ED RNs and identify gaps to be ameliorated through continuing education and policy implementation.University of Ontario Institute of Technology and Trent Universit
Promising practices used by International Medical Graduate Physicians to increase cervical screening in South Asian and Chinese immigrants in the Greater Toronto Area
Full text linkCervical cancer is one of the most preventable cancers, with Pap tests being a widely accessible form of screening throughout Canada. However, participation in cervical cancer screening is historically lower in South Asian and Chinese immigrants. Previous literature showed that the risk of being under-screened is even higher for these women if they receive care from a provider that is from a culturally congruent region. This investigation aimed to qualitatively explore this phenomenon through the perspective of South Asian and Chinese International-Medical Graduate (IMG) physicians. Semi-structured interviews were conducted to identify barriers to cervical screening faced by South Asian and Chinese immigrants across the Greater Toronto Area (GTA), as well as promising practices that are currently being used by IMG physicians to increase cervical screening participation among their patients. Several barriers to and interventions designed to screening were identified at the individual, community, and health care provider level. Promising interventions include linguistically and culturally appropriate health education and access to a female provider.University of Ontario Institute of Technolog
Navigating life with heart failure: the realities of self-care practices for patients and their families following cardiac rehabilitation
Full text linkHeart failure (HF) self-care is well-documented in HF management, yet the experiences of patients and family members post-cardiovascular rehabilitation (CR) are less explored. This qualitative study utilized semi-structured interviews to probe into the post-CR self-care experiences among patients with HF and their families. Employing the Health Belief Model (HBM) as a guiding framework and interpretative phenomenological analysis (IPA) for data analysis, the research unveiled 14 interconnected themes rooted in the HBM's core elements: perceived susceptibility, perceived severity, cue to action, perceived benefits, perceived barriers, and self-efficacy.
The insights gleaned from this study hold significant implications for clinical practice, policy, and future HF management research. The findings offer a nuanced understanding of intricacies behind behaviour change in patients with HF and their families, guiding targeted interventions and policy adjustments for improved care and support.University of Ontario Institute of Technolog
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