Browsing by Author "Guichon, Juliet"

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    Barriers, supports, and effective interventions for uptake of human papillomavirus- and other vaccines within global and Canadian Indigenous peoples: a systematic review protocol
    (2018-03-02) Mrklas, Kelly J; MacDonald, Shannon; Shea-Budgell, Melissa A; Bedingfield, Nancy; Ganshorn, Heather; Glaze, Sarah; Bill, Lea; Healy, Bonnie; Healy, Chyloe; Guichon, Juliet; Colquhoun, Amy; Bell, Christopher; Richardson, Ruth; Henderson, Rita; Kellner, James; Barnabe, Cheryl; Bednarczyk, Robert A; Letendre, Angeline; Nelson, Gregg S
    Abstract Background Despite the existence of human papilloma virus (HPV) vaccines with demonstrated safety and effectiveness and funded HPV vaccination programs, coverage rates are persistently lower and cervical cancer burden higher among Canadian Indigenous peoples. Barriers and supports to HPV vaccination in Indigenous peoples have not been systematically documented, nor have interventions to increase uptake in this population. This protocol aims to appraise the literature in Canadian and global Indigenous peoples, relating to documented barriers and supports to vaccination and interventions to increase acceptability/uptake or reduce hesitancy of vaccination. Although HPV vaccination is the primary focus, we anticipate only a small number of relevant studies to emerge from the search and will, therefore, employ a broad search strategy to capture literature related to both HPV vaccination and vaccination in general in global Indigenous peoples. Methods Eligible studies will include global Indigenous peoples and discuss barriers or supports and/or interventions to improve uptake or to reduce hesitancy, for the HPV vaccine and/or other vaccines. Primary outcomes are documented barriers or supports or interventions. All study designs meeting inclusion criteria will be considered, without restricting by language, location, or data type. We will use an a priori search strategy, comprised of key words and controlled vocabulary terms, developed in consultation with an academic librarian, and reviewed by a second academic librarian using the PRESS checklist. We will search several electronic databases from date of inception, without restrictions. A pre-defined group of global Indigenous websites will be reviewed for relevant gray literature. Bibliographic searches will be conducted for all included studies to identify relevant reviews. Data analysis will include an inductive, qualitative, thematic synthesis and a quantitative analysis of measured barriers and supports, as well as a descriptive synthesis and quantitative summary of measures for interventions. Discussion To our knowledge, this study will contribute the first systematic review of documented barriers, supports, and interventions for vaccination in general and for HPV vaccination. The results of this study are expected to inform future research, policies, programs, and community-driven initiatives to enhance acceptability and uptake of HPV vaccination among Indigenous peoples. Systematic review registration PROSPERO Registration Number: CRD42017048844
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    How do people with disabilities perceive advance care planning?
    (2017) Gray, Robin; Crocker, Cheryl; Simon, Jessica; Guichon, Juliet; Duggleby, Wendy; Atkins, Chloe
    Advance care planning is the process of reflection and communication of one's preferences for future care. Technological and medical advances have made it possible for people to live longer. It is likely that many people will live with a disability. This study aimed to understand how people with physical and/or sensory disabilities perceive advance care planning. One-to-one interviews were conducted with eleven adults aged 40 - 74 years, who self-identified as having a physical and/or sensory disability. The study was designed, interviews were conducted, and data were analyzed using Charmaz’ grounded theory. Participants' two main concerns emerged: health care provider lack of awareness of disability and aging with disability. Participants adopted planning for present and future health or illness as the means to address barriers in health encounters. A theoretical approach grounded in Self-Determination Theory, Self-management, and the Collaborative Care in Chronic Illness Model was derived.
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    Psychological Distress in Emergency Medical Services Practitioners: Identifying and Measuring the Issues
    (2017) Lefevre, Nicola Louise; Doig, Christopher; Mitchell, Ian; Page, Stacy; Guichon, Juliet; McLaughlin, Kevin
    This thesis investigates psychological distress in Emergency Medical Services practitioners through three pieces of inter-related research. The first examines the prevalence of compassion fatigue in all health care practitioners by systematic review of literature. The second conceptualizes three manifestations of distress (compassion fatigue, burnout, and post-traumatic stress disorder), places them in the context of EMS work by describing practitioners’ experience, and broadly strategizes ways to address them. The third measures the presence of compassion fatigue, burnout, and post-traumatic stress disorder in a sample of EMS practitioners through a survey based study. Overall, the research showed that EMS practitioners are experiencing psychological distress as compassion fatigue, burnout and PTSD, and that compassion fatigue has been identified across diverse practitioner groups in health care. Recommendations are consistently made that further research needs to be conducted to investigate root causes, and that education and support programs would be of benefit to practitioners.
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    Social Workers' Experience of Moral Distress
    (2016) Jaskela, Shannon; Mitchell, Ian; Page, Stacey; Guichon, Juliet
    According to Jameton (1985), “moral distress arises when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action” (as cited in Pendry, 2007, p.1). The issue of nurses and moral distress has been studied extensively; however, little attention has been paid to social workers’ experience of moral distress. The main objectives of this qualitative descriptive research were to explore whether ten health care social workers experienced moral distress and, if so, what were the causes and effects of such moral distress. The supports they use to deal with such distress were also explored. The participants voiced that they experience moral distress from a variety of sources and that the effects of such distress can result in exhaustion, apathy towards patients, and social workers leaving their positions. The results of this research are discussed and suggestions for further research and practice are presented.
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    “The Third Sex” – A study of distress in physicians
    (2017) Kenny, Kathryn May; Mitchell, Ian; Brain, Philippa; Guichon, Juliet; Raffin Bouchal, Donna Shelley
    The purpose of this inquiry was to gain a rich and deep understanding of the lived experiences of physicians who engage in Disorders of Sexual Development (DSD) diagnosis, disclosure and management. The primary aim of this inquiry was to achieve an in-depth understanding of ethical and/or moral dilemmas, emotions, feelings, and challenges that may arise in DSD counselling, and to begin to understand the meaning behind these experiences, and how physicians shape their practices based on these experiences. Hermeneutic phenomenology was selected as the most appropriate method of qualitative research as outlined by Max Van Manen. Open ended unstructured interviews were conducted with seven physicians of various specialties in the Calgary Zone of Alberta Health Services who work with patients under the age of eighteen. DSD diagnosis and counselling was revealed to be a distressing clinical encounter for physicians in my study; however, the origin as well as depth to which physicians perceive an impact on their clinical practice is quite variable. Physicians are faced with varying degrees of uncertainty in DSD counselling and all specialties acknowledge its presence. Physicians have uniquely adapted practice styles to minimize the effect of this uncertainty. Physicians involved in the surgical dimension of the DSD counselling experience describe the possible violation of the ethical principle non-maleficence as a source of personal distress. Poor communication, as embodied in the form of mixed diagnostic and management messages between various multidisciplinary health care team members and the parents of DSD infants/children, contributes to physician anxiety. Lastly DSD counselling is made more difficult by the societal and sometimes cultural expectations placed on families. The interpretive description of this inquiry has the promise to help readers gain a greater understanding of the essence of DSD counselling from the perspective of the physician. I hope the rich descriptions provided in the analysis section of this paper will compel each reader of this paper to advocate for DSD patients whether or not they are directly involved in healthcare. Increased exposure and education, framed within a positive perception, is critical to the improvement of the lives of DSD patients throughout the world.