Browsing by Author "Carr, Eloise C. J."

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    Effect of Alberta Family Integrated Care (FICare) on Breastfeeding Self-Efficacy and Breastmilk Feeding in Moderate and Late Preterm Infants
    (2019-07-03) Brockway, Meredith L.; Benzies, Karen Marie; Carr, Eloise C. J.; Aziz, Khalid
    Background: Breastfeeding self-efficacy (BSE) predicts breastfeeding outcomes in mothers of full-term infants; however, neonatal intensive care unit (NICU) practices may impede BSE and breastmilk feeding in mothers of preterm infants. Alberta Family Integrated Care (FICare) integrates parents into the care of their infant while in the NICU, by enhancing parent support, parent education and information sharing. The objective of this PhD work was to explore how Alberta FICare works to inform maternal BSE and resultant infant feeding outcomes in mothers of moderate (320/7 – 336/7 weeks) and late preterm infants (340/7 – 356/7 weeks). Methods: I conducted an explanatory sequential mixed-methods sub-study of the Alberta FICare trial. Based on BSE change scores between admission and discharge for mothers in the intervention group, I invited mothers scoring in the top or bottom quintiles to participate in interviews about infant feeding experiences in the NICU. Interviews were analyzed using inductive thematic analysis. To assess the effects of FICare on BSE and breastmilk feeding rates at discharge, I used repeated measures ANCOVA and Chi square. Finally, I used an integration matrix to integrate qualitative and quantitative findings. Results: Overall, I included 457 mothers/infant dyads (70 twins; M = 336/7 weeks gestation) from the FICare trial. Interviews with 14 mothers revealed three major themes: (a) institutional influences, (b) relationship with the pump, and (c) establishing breastfeeding. FICare was effective at improving BSE for mothers of late preterm infants, F(1, 232) = 3.97, p = .048, partial η2 = .017, but not for mothers of moderate preterm infants, F(1, 191) = 0.79, p = .375. Although exclusive breastmilk feeding rates at discharge in late preterm infants enrolled in the FICare group were higher compared to the standard care group, these differences were not statistically significant, 72.3% versus 62.2%, χ2(1) = 2.90, p = 0.089; no notable difference in exclusive breastmilk feeding was observed in moderate preterm infants. Conclusion: FICare is an effective model of care to improve BSE in mothers of late preterm infants at discharge from the NICU. More research is required to understand why FICare did not improve BSE in mothers of moderate preterm infants.
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    An Integrative Review of Barriers to Pain Management: Implications for Future Improvement Initiatives
    (2013-11) Ortiz, Mia Maris; Carr, Eloise C. J.; Dikareva, Anastasia
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    Perception of Interprofessional Learning during an Interprofessional Collaborative Care Pain Clinic Elective: An Embedded Mixed Methods Study
    (2021-02-01) Shinkaruk, Kelly Shallen; Hecker, Kent; Carr, Eloise C. J.; Lockyer, Jocelyn M.
    A changing landscape of complex medical conditions, in particular chronic pain, incorporates the use of interprofessional collaboration (IPC) to offer holistic patient care. Interprofessional education (IPE) and interprofessional learning (IPL) provide health professions students with the means of attaining IPC competencies and, furthermore, they catalyze dual professional identity development. This study was designed to explore the manner in which medical students perceive IPL during a clinical elective at an interprofessional pain clinic and whether this exposure led to any change in their favourability for IPL. Fourteen medical students from a variety of Canadian medical schools participated in this embedded mixed methods research study, which included pre- and post-elective surveys and in-person semi-structured interviews. Descriptive statistics and nonparametric sign testing were performed on the survey data and thematic analysis was utilized for the qualitative interview data. Quantitative analysis revealed that medical students competing this clinical elective were favourable to IPL at both time points and that no significant change occurred following the elective. Thematic analysis led to the description of a model demonstrating the elements contributing to the development of a dual professional identity. This model consisted of three major themes and three overarching moderating and mediating factors. Learning about allied health professionals, learning about how IPC teams function, and recognizing the benefit of IPC were key to gaining IPC competencies in the context of repeated exposure to IPL, active participation, and reflection. In addition, perceptions of IPC specifically related to a pain clinic setting were identified. Future directions include ensuring adequate faculty development for IPC as well as incorporating purposive IPL and facilitated reflection opportunities into clinical rotations.