Browsing by Author "King-Shier, Kathryn M."

Now showing 1 - 8 of 8
  • Thumbnail Image
    ItemOpen Access
    Being Uncertain: Rural Living Cardiac Patients' Experience of Accessing Healthcare
    (2020-01-06) Lowe, Erin; King-Shier, Kathryn M.; Banner-Lukaris, Davina; Estefan, Andrew
    Cardiovascular disease is a leading cause of morbidity and mortality worldwide and secondary prevention strategies such as physical activity, diet and weight management, stress management, emotional health, and education are necessary to reduce disease progression to heart failure. Although cardiac rehabilitation has also been demonstrated to improve quality of life and well-being, services tend to be underutilized worldwide, particularly in rural populations. Thus, Straussian Grounded Theory was used to seek a deeper understanding of the process that rural cardiac patients go through to access healthcare and cardiac rehabilitation following myocardial infarction. In-depth interviews with eleven participants were untaken resulting in emergence of several themes. Qualitative themes that emerged included comfort with health information, relationship with healthcare providers, social support, taking ownership, and availability of/for cardiac rehabilitation. These events occurred throughout a linear timeline progressing from hospital discharge to maintaining health. The core category of ‘being uncertain’ refers to the process rural cardiac participants will go through while accessing care after their myocardial infarction. Gaining an understanding of the process rural patient go through to access care after their myocardial infarction will assist in identifying ways to improve access and address uncertainty stemming from a lack of perceived information at and post-discharge.
  • Thumbnail Image
    ItemOpen Access
    Clinical Leadership Development Workshops for Licensed Practical Nurses in Supported Living in Alberta: An Exploratory Qualitative study
    (2020-03-27) Enghiad, Parivash; Venturato, Lorraine; Ewashen, Carol J.; King-Shier, Kathryn M.; Raffin-Bouchal, Shelley
    Aim: This study had three aims: 1) to develop and deliver a clinical leadership development (CLD) workshop for licensed practical nurses (LPNs) who work in supported living (SL) contexts; 2) to explore LPN participants’ experiences, as well as the influence of the workshop on their attitudes, knowledge, and skills; and 3) to explore the feasibility of implementing a work-based CLD workshop for LPNs working in SL in Alberta. Background: Effective clinical leaders create an efficient and caring work environment, resulting in quality care for patients that attend to both their physical (e.g., safety) and psychological (e.g., autonomy) needs. In SL in Alberta, nursing care is primarily undertaken by LPNs, who work with both registered nurses (RN) and health care aides (HCA) in delivering quality care to older adults. As a result, LPNs are required to undertake clinical leadership (CL) roles that they are often under-prepared for. CL requires the development of a new set of skills for LPNs. To date, few resources have been devoted to developing educational programs to teach these skills, particularly in relation to work-based learning. This program addressed the issue of improving LPNs’ CL skills by developing and delivering a work-based CLD workshop. Design: An exploratory qualitative design was used, incorporating multiple data collection methods, including individual and focus group interviews, a demographic questionnaire, and a knowledge questionnaire. Interview data were analyzed using thematic description and the knowledge questionnaire data were statistically analyzed using a Wilcoxon signed-rank test. Result: The themes were captured in the findings: exploring and raising awareness of the LPNs role as a clinical leader; a sense of empowerment for LPNs in their role as clinical leader; the influence of the CLD workshop on teamwork and communication; and feasibility’s facilitators and challenges. The data affirmed the need for developing a program to help LPNs improve their CL skills, and understand and undertake their CL roles and responsibilities. The effectiveness of the CLD workshop was demonstrated through the LPN participants’ increased confidence, autonomy, and perceived control over decision-making. Following the workshop, the participants expressed a sense of empowerment, which resulted in changed attitudes about their capacity and their role. Conclusion: This study has shown the importance of LPNs understanding their role as a clinical leader, developing effective communication skills, and establishing a working relationship with and among their staff; it has also shown the significance of empowering LPNs. Limitations of the study included challenges arranging and scheduling the necessary time for LPNs to attend CLD workshop, availability and sustainability of the CL training for new staff, and refresher training for the existing staff.
  • Thumbnail Image
    ItemOpen Access
    The Experiences of Individuals Re-engaging in Sexual Relationships Following a Bone Marrow Transplant
    (2019-07-19) Shartau, Kristi; King-Shier, Kathryn M.; Booker, Reanne; Bouchal, Shelley Raffin
    More than 50,000 individuals worldwide receive a bone marrow transplant annually, and this incidence is increasing. Sexual function is a common long-term concern after a bone marrow transplant (BMT). Studies have demonstrated though important to patients, healthcare providers are often remiss in addressing these concerns. Thus, Straussian Grounded Theory was used to seek a deeper understanding of the process BMT patients undergo to reintegrate their sexual relationships following a bone marrow transplant. Qualitative themes that emerged included: identifying importance, taking responsibility, seeking resources, and navigating the partnered-relationship. Gender permeated each of these themes. These events occurred in a non-linear process of seeking a new normal and could apply at any time point during the treatment trajectory. The core category of seeking a new normal’ refers to the process participants will go through while searching for ‘normalization’ and trying to get back to the condition they were in before diagnosis. Gaining an understanding of the process patients go through when integrating back into their sexual lives post-transplant will facilitate awareness about the impact a transplant can have on a patient’s sexual health.
  • Thumbnail Image
    ItemOpen Access
    The Impact of Severity, Timing, and Sex on Outcomes of Inpatient Stroke Rehabilitation
    (2020-01-08) Tanlaka, Eric Fover; King-Shier, Kathryn M.; Dukelow, Sean P.; Venturato, Lorraine; King-Shier, Kathryn M.; Dukelow, Sean P.; Green, Theresa L.; Seneviratne, Cydnee C.; Ewashen, Carol J.; Teasell, Robert
    Stroke severity and time to rehabilitation admission are important factors in influencing stroke rehabilitation outcomes. We aimed to determine the impact of: (1) stroke severity and timing to inpatient rehabilitation admission on length of stay, functional gains, and discharge destination; and (2) age and sex differences in time to rehabilitation, length of stay in rehabilitation, and discharge destination for stroke patients in Alberta. The first manuscript offers a discussion of post-positivist critical multiplism and its value for nursing research and describes the steps for conducting critical multiplist nursing research using stroke rehabilitation as an example. We identify that post-positivist critical multiplism offers a useful, rigorous approach that relies on a step-by-step method and a collaboration with a team of scholars who offer different perspectives, open questioning and critique, and rigorous attention to minimize biases throughout the research process. We examined a large retrospective cohort to address the research aims. In the second paper, we identified that length of time to rehabilitation admission was not significantly different between stroke severities. Individuals with moderate and severe stroke made significantly larger FIM gains than mild stroke during inpatient rehabilitation. LOS was longer with increasing stroke severity. Time to inpatient rehabilitation admission had small, but significant impacts on functional gains and LOS. Patients with shorter times to rehabilitation admission and those with mild stroke were more likely to be discharged home without needing health services. In the third paper, we identified that mean length of time from acute care admission to inpatient rehabilitation admission was not significantly different between males and females. There was no significant difference in mean FIM change between males and females during inpatient rehabilitation. Mean LOS in rehabilitation was slightly longer among females compared to males. Male patients and those of younger age were more likely than females and those of older age to be discharged home without needing homecare. In conclusion, stroke severity had a significant impact on the conduct of inpatient rehabilitation. The impact of timing on functional gains and LOS was small. Differences in LOS and discharge destination based on sex and age were significant.
  • Thumbnail Image
    ItemOpen Access
    The Implementation of Correctional Nursing Practice in Alberta: A Grounded Theory Study
    (2020-08-10) Dhaliwal, Kirnvir Kaur; Hirst, Sandra P.; King-Shier, Kathryn M.; Kent-Wilkinson, Arlene E.
    Introduction: In three Canadian provinces, offenders in provincial custody receive healthcare services from health authorities, rather than correctional services. Alberta made the care transition to the health authority in 2010. The governance of correctional healthcare services by health authorities, and not the correctional services, may be advantageous as healthcare professionals are possibly less likely to experience tension between corrections (custody) and health (caring) priorities. There is uncertainty about if and how this tension between custody and caring still exists and is experienced by Canadian registered nurses (RNs) practicing in provincial custody with healthcare governance by health authorities. Therefore, the aim of this doctoral research was to study how RNs implement their nursing practice in the Alberta provincial custody correctional system. Method: Straussian grounded theory approach was used. Simultaneous data collection and analysis were undertaken using theoretical sampling, constant comparison, and memo writing. RNs (n = 13) engaged in semi-structured telephone interviews, focused on the experience of implementing their correctional nursing practice and providing nursing care to offenders. Data were collected until saturation occurred. Analytic coding (open, axial, and final theoretical integration) was performed to identify the core category (Caring Behind Bars) and its six subcategories around which the substantive theory was developed. Findings: The theory of Caring Behind Bars refers to the process of how RNs implemented their correctional nursing practice to care for the offender population. RNs possessed a foundational stance regarding what nursing practice means to them in general. Upon entering the correctional context, RNs experienced tension between custody and caring. RNs engaged in adaptability and advocacy to address this tension and access the offender population. The provision of care required RNs to take numerous actions – interactions to provide care to offenders. The consequences of Caring Behind Bars were challenging and positive outcomes. Significance: The research resulted in the development of foundational knowledge to advance Canadian correctional nursing practice and offered potential insights into promoting offender health.
  • Thumbnail Image
    ItemOpen Access
    A Prospective Proof-of-Concept Study Evaluating the Influence of Patient Education on Knowledge, Attitudes, and Cardiac Rehabilitation Attendance among Patients with Coronary Artery Disease
    (2019-08-23) Williamson, Tamara Marie; Campbell, Tavis S.; Rouleau, Codie R.; King-Shier, Kathryn M.; Doyle-Baker, Patricia K.; von Ranson, Kristin M.
    Patient education (PE), delivered during cardiac rehabilitation (CR), aims to promote CR exercise attendance by imparting knowledge about coronary artery disease (CAD; medication, risk factors, etc.) and enhancing CR-related attitudes. This study evaluated the impact of PE on motivational treatment targets (CAD knowledge, CR attitudes), and CR exercise attendance. Adults (18+) with CAD referred to CR were recruited prior to attending PE. CAD knowledge and CR attitudes (perceived necessity/suitability, exercise concerns, barriers) were assessed pre/post-PE, and at 12-week follow-up. CR exercise attendance was obtained by chart review. Seventy-one patients (87% male) participated. CAD knowledge and perceived CR necessity improved pre- to post-PE; gains persisted at 12-weeks. Greater knowledge gains did not predict larger improvements in CR attitudes or increased exercise attendance. Whereas CR-based PE may be useful for improving CAD-related knowledge and perceived need for CR, more formative work is needed to determine whether PE can promote CR exercise attendance.
  • Thumbnail Image
    ItemOpen Access
    The Role of Social Support in Peritoneal Dialysis Management and Outcomes
    (2019-07-09) Fox, Danielle Eleri; King-Shier, Kathryn M.; Quinn, Robert Ross; James, Matthew Thomas; Venturato, Lorraine
    Peritoneal dialysis (PD) is an effective and cost-efficient renal replacement therapy that enables patients to maintain their independence at home. Unfortunately, technique failure is common and social support is necessary for PD success. The objective of this mixed methods study was to understand the significance and meaning of support in the PD context. Having a support person had a protective effect against technique failure between 3 and 12 months from the onset of PD. Social support was an important part of the PD experience, however, social support needs varied and were dependent on existing support networks and individual perspectives of support. To sustain patients on PD, the breadth of social support needs must be understood by healthcare providers and individualized to the patient/family.
  • Thumbnail Image
    ItemOpen Access
    Will women interact with technology to increase physical activity?
    (2018-08-09) Hildebrand, Kathy Louise; King-Shier, Kathryn M.; Tompkins-Lane, Christine; Venturato, Lorraine
    Background: Cardiovascular disease continues to be one of the leading causes of death for women. New approaches need to be identified that will enable women to recognize modifiable risk factors (i.e., smoking, diabetes, physical inactivity, high blood pressure, high blood cholesterol and obesity) and target their efforts towards prevention. Technology is increasingly being accessed by individuals to understand components of their health. A sensor-based activity monitor, with the novel web-based platform VivametricaTM and a small amount of personal health information, can provide a personalized cardiovascular health risk score. Objectives: The objectives of this study were to examine: 1) if women would wear a Garmin Vivosmart® HR Wrist Tracker (GVWT) and access VivametricaTM to assess information about their cardiovascular health risk; 2) whether using the VivametricaTM tools would lead women to increase their physical activity, as measured by their daily step counts; and 3) women’s opinions about using VivametricaTM. This study was undertaken in two phases using quantitative then qualitative methods. The first phase addressed objectives #1 and #2. The second phase addressed objective #3. Methods: Phase one was a prospective observational study involving thirty-six English speaking women aged 45-64 years old, without physical disabilities. Participants wore a GVWT for 12 weeks and were instructed in how to access the VivametricaTM platform. The number of times participants accessed VivametricaTM and participants’ physical activity (step count) were streamed via the GVWT to VivametricaTM. The number of steps data were analyzed from those participants who accessed VivametricaTM (during the 12 week period) using Wilcoxon signed rank test to compare the median number of steps walked during the participants’ first 14 days (T1) with median number of steps walked during the last 14 days (T2). Phase two was a qualitative descriptive study whereby all participants in phase one engaged in semi-structured audio-recorded interviews. Qualitative content analysis, using the technology assessment model, was used to analyze the text data. Results: Twenty-six (72%) participants accessed VivametricaTM over the course of the study. The median number of steps at baseline and at 12 weeks were 9329 steps (range 5406-18228 steps) and 10181 steps (range 5398-21401 steps) respectively. There was no significant change in number of steps taken by the participants over the 12 week period (Z = -1.143, p =.253). Although the change in steps was not statistically significant, it represents an average increase in daily steps of 9%, which is clinically important. Four themes were identified from the qualitative interviews. They were: confusion, convenience, measurement, and sleep. Confusion resulted for some participants when two forms of technology were introduced at the same time. The participants expected using the technology to be convenient and effortless. Yet, having to sign onto a computer to see their health scores was frustrating for many women. The GVWT was effortless when in the mode of collecting steps. However, if a participant wanted to capture other activity, such as cycling, they needed to change the mode. The women did not like having to adjust any settings on the GVWT. The value of measurement meant different things to different women. Knowing their health scores and activity awareness were valued by the participants. However, some participants found having missed data (e.g., in the case of forgetting to wear the GVWT not appropriately changing the mode on the GVWT) frustrating and discouraging. Finally, participants sought out other information when using the technology and this was focused on their sleep patterns. Some participants changed their behavior to achieve better sleep. Discussion: VivametricaTM provides more than activity data, thereby allowing a unique option for individuals to access personal health risk information. This innovative technology has great potential for supporting women to understand their personal CVD risk. However, people who use this technology need to be trained and supported with resources to enable them to use this technology to its capacity.