Abstract
Thematic synthesis: The experience of spouses of women with breast cancer
Rhyquelle Neris, Federal University of Uberl##x00E2;ndia
Anna Cláudia Yokoyama dos Anjos, Federal University of Uberl##x00E2;ndia; University of São Paulo
Márcia Maria fontão Zago, University of São Paulo
Miriam Lopes, University of São Paulo
The aim of this study was to analyze and synthesize the primary studies that addressed the experiences of the spouses of women with breast cancer, presenting the current state of knowledge. The sample was composed of eight studies, published between 2000-2012, retrieved in databases BVS, PUBMED, CINHAL using the crossing of the DECs descriptors: “breast neoplasms/neoplasias da mama”, “qualitative research/pesquisaqualitativa”, “family/família”, “spouses/c##x00F4;njuges”. The main themes were: changes in the couple relationship; changes in role performance; hope for cure; impaired sexual activity; emotional and social difficulties; care needs to husband and the importance of religion and faith. The results of the studies point to the involvement and care experiences of husbands over sickened wives. It highlights the need for attention and assistance towards these spouses, as well as guidance and education to exercise the care, how it has been done by the team of health to these women. Through this study we observed the importance of support groups for spouses, where they can meet other spouses and share their fears and concerns, as well as receiving health team the support they so desperately need. It is necessary that care should be integral, directing care to the entire family, including the spouse, not being restricted care only to the patient with cancer. We emphasize the importance of further studies to deepen the knowledge, know people with different characteristics and sociocultural contexts, seeking to enhance assistance to the population served also in our reality.
Psychotherapeutic interventions for stress reduction in women with breast cancer: An integrative literature review
Grasielle de Sousa Igídio; Federal University of Uberl##x00E2;ndia
Anna Cláudia Yokoyama dos Anjos, Federal University of Uberl##x00E2;ndia; University of São Paulo
Márcia Maria fontão Zago, University of São Paulo
Miriam Lopes, University of São Paulo
Women with breast cancer report high levels of stress, hindering their psychological adaptation. The aim of this study was to synthesize the knowledge related to psychotherapeutic practice for stress reduction. An integrative review of national and international literature was performed using publications between the years 2003 and 2013. The sample consisted shape 12 studies retrieved in PUBMED database and Portal Search BVS, using the keywords: “psychological stress”, “breast neoplasms” and “psychotherapy”. The predominance of techniques based on Mindfulness Stress Reduction and Cognitive Behavioral Stress Management, touted as an important resource for reducing stress. The synthesis allowed seeing which interventions are feasible for the peculiarities of this group. All studies used the quantitative methodology. Questions whether such subjective aspects do not require qualitative studies to further deepening of the social and psychological aspects involved in breast cancer-related stress. There was no national studies, and, therefore, suggest that they are performed to verify the applicability of these interventions in the Brazilian population.
The role of nursing in genetic counseling related to breast cancer
Anna Cláudia Yokoyama Dos Anjos, Federal University of Uberl##x00E2;ndia; University of São Paulo
Laís Durant, Federal University of Uberl##x00E2;ndia;
Márcia Maria fontão Zago, University of São Paulo
Nayara Cunha, Federal University of Uberl##x00E2;ndia.
Introduction: Currently, the knowledge about the genetic and cancer related issues involved in patient care and their families has been the subject of increasing number of studies and improvement of the performance of nursing. With regard to breast cancer, there is a low, however important hereditary risk. Objective: to know how the performance of nursing has happened in genetic counseling related to breast cancer. Method: it is a systematic review of the literature, thematic synthesis mode. In this abstract the partial results of the review are presented. Extensive searches were held in the databases CINAHL, Embase, VHL and PubMed, using the key words breast cancer, brca1 gene, brca2 gene, genetic counseling, nursing. Inclusion and exclusion criteria for selection of the studies were estamblished that will compose the sample. A primary evaluation of abstracts was held seeking to characterize studies and group them by themes. Previous results: from 42 studies retrieved, 14 studies were pre-selected for analysis of the abstracts. The results presented in the abstracts were grouped in 5 major themes: 1) Role of the nurse in genetic counseling; 2) Oncogenetic as a public health challenge; 3) Tough choices; 4) Satisfaction of women; 5) Male Contribution. The complete analysis of the studies will be conducted to develop and complete presentation of this review.
We really don't have a clue’: An Interpretive Description of the Information Needs of Parents with a Child with Asthma
Mandy Archibald, University of Alberta
Shannon Scott, University of Alberta
Vera Caine, University of Alberta
Samina Ali, University of Alberta
Lisa Hartling, University of Alberta
Over the past twenty years, substantial strides have been made in understanding childhood asthma, including its pathophysiology and the effectiveness of available therapies. This progress has sub-optimally translated into improvements in asthma management or healthcare utilization for children. Inconsistent provision of meaningful parental asthma-education has contributed to this problem. When provided, asthma education often reflects medical priorities and inconsistently integrates parents' values and priorities. Identifying the information needs of parents who have a child with asthma is an essential first step towards integrating parental perspectives in education and to improving parental education, management practices, and ultimately, childhood asthma outcomes. To identify how parents of a child with asthma identify and prioritize their information needs, we conducted a qualitative study, guided by interpretive description. We conducted 20 semi-structured interviews with 21 parents who have a child with asthma with varied backgrounds, illness trajectories, and management scenarios. We sampled our population from three diverse clinical settings in Edmonton, Alberta (October 2011-May 2012). Data were analyzed thematically to identify common themes within and across cases. Parents were challenged to identify their asthma-related information needs, which impacted information seeking behaviours and management decisions. Parents frequently reported receiving little to no education about asthma or its management, contributing to a disconnect between participants' knowledge and comfort with asthma management, and their time since diagnosis. Perspectives of asthma as an acute condition were common. Findings illuminate shortcomings in how healthcare practitioners address parents' information needs and highlight the need for comprehensive, patient-driven asthma education.
Patient perspectives of living with severe obesity in the context of activities of everyday living
Jodie Asselin, University of Alberta
Mary Forhan, University of Alberta
There is limited understanding by health care professionals about what daily life is like for patients living with severe obesity. The purpose of this study was to gain a better understanding of the experiences of patients living with this condition in the context of everyday living. Responses from 53 participants to the following open-ended question ‘Is there anything else that you would like to tell us about your experiences in daily living with obesity?’ were analyzed. This question was located at the end of a questionnaire package containing measures of quality of life, disability status, social support and time use. Using thematic analysis, 7 primary codes were identified: mobility, work, social life, actions of others, opinions of others, feelings, and physical symptoms and challenges. Identified themes included a trend towards increased effort in daily tasks, increase in social stress, and decreased participation in pleasurable and meaningful activities. Further analysis of these themes revealed a strong resilience and drive necessary to live with such challenges. Exploring the lived experience of patients with severe obesity in the context of their everyday lives illuminates life realities and substantiates results from quantitative analysis of data collected from the same sample. Future work is needed to address the barriers to participation in daily life for patients with obesity while utilizing the strengths of this population.
What's Love Got to Do with It?: Fostering Romance to Maintain Father Involvement
Constance Dallas, University of Illinois-Chicago, College of Nursing
Patrick McMahon, University of Illinois at Chicago
Barbara Dancy, University of Illinois at Chicago
Claire Seryak, University of Illinois at Chicago
Jamela Jefferson, University of Illinois at Chicago
Fathering children with two or more partners is associated with their subsequent decreased involvement with their children. Positive father involvement, regardless of the father's residential status, increases the potential for positive child outcomes. Data are part of an ongoing grounded theory study in which we examine factors that influence father involvement of low-income, African American men who parent across households. We conduct individual in-depth interviews with each member of 10 -12 fatherhood networks, usually in their homes. Each fatherhood network includes: the father and mothers of his children, their current romantic partners and parents, and up to three additional influential persons. Preliminary data reveal some fathers use romantic attachments to maintain access to, and involvement with, their children. Three fathers are presented here. Jamaar, who has custody of two pre-school aged children, utilized rapidly shifting romantic attachments to provide shelter, additional financial resources, and female parenting models. Montel has maintained daily access to his three adolescent children via 12-year continuous romantic attachments with both mothers of his children. The mother of Emmett's youngest child repeatedly threatened to put him out of her home and deny him access to his son. Emmett's romantic attachment to her provides daily access to his son and a place to live. Fathers who are living in poverty and are committed to maintaining involvement with their children may rely on non-traditional strategies, such as fostering romantic attachments, to accomplish their basic parenting functions. We address policy implications and potential risks for subsequent pregnancies for these fathers.
Challenges of participatory action research in rural communities
Virginia Dickson-Swift, La Trobe Rural Health School, La Trobe University
Mandy Kenny, La Trobe Rural Health School, La Trobe University
Jane Farmer, La Trobe Rural Health School, La Trobe University
Recent health care reforms in Western countries have emphasised the need for public and patient involvement. As part of this process it has been imperative to involve service users and community members in decisions about treatment, service development and evaluation. The terms participation, engagement and involvement are often used interchangeably as if they are one and the same. We have seen this reflected in health policy reforms and there has been debate both within Government and the media about the usefulness of involving community members in decisions about health service delivery. New models of community participation in service design emphasise the importance of co-production. Models of co-production provide service users, organisations and communities with a mechanism to come together to design services that respond to local need.
In this paper we provide an overview of our qualitative project based in rural Australia that used a community based participatory action research method to address a range of health and wellbeing issues identified by local communities. We outline the methodological and practical challenges of research and highlight how local community members and user groups can become co-producers of health care policy and practice and both an individual and community level.
From well being to good death: a nursing model for the recognition and management of delirium in palliative care
Mohamed El Hussein, Mount Royal University
Joseph Osuji, School Of Nursing, Mount Royal University
Hirst Sandra, Faculty of Nursing, University of Calgary
Nursing care enacted within the confines of relationships and appropriate nurse-client-family relationships in palliative care have shown to add value to the experience of clients and families. Palliative care is empowering to patients, and has pure motive of creating circumstances that will make good death possible. The concept of good death assumes that life and wellbeing must continue until death occurs and is evidenced by the retention of mental awareness and control, being comfortable, achieving a sense of closure and optimizing relationships. It is through attending to questions relating to relationships that nursing finds its meaning. Delirium is a well recognized neuropsychiatric barrier to quality of life that affects up to 20-40% of palliative patients. Delirium is characterized by an acute change in cognition, fluctuating consciousness, confusion and restlessness. Delirium has significant relational challenges to the end of life experience for patients and families negatively impacting the experience of a good death. Unfortunately, delirium is underrecognized and undertreated. Thus, palliative care nursing aimed at fostering well being among people with critical health situations through compassionate care and clinical excellence is an ideal paradigm of care under these circumstances. However an important question therefore is whether the nurse-client-family relationship can be enacted fully in the presence of delirium in the palliative client and whether early recognition of delirium will enhance this relationship and make possible the experience of good death. Our presentation discusses an emerging model depicting a pragmatic and holistic approach to structure care to recognize delirium in palliative patients.
Challenges of Integrating Modern and Traditional Medicine in Non-Communicable Disease (NCD) Prevention in Sri Lanka
Machiko Higuchi, National College of Nursing, Japan
Chandani Liyanage, University of Colombo, Sri Lanka
In Sri Lanka, where demographic and epidemiologic transitions have occurred over the past few decades, rapid changes in disease patterns have also occurred, and non-communicable diseases have become a leading threat to human development. Mortality and disease burden from these health issues are expected to increase if not addressed. Indigenous medicine in Sri Lanka, which comprises varieties of Ayurveda, Siddha, Unani and deshiya Chikitsa, has been expected to provide countermeasures for NCD prevention, but few studies have evaluated the effectiveness and efficacy of indigenous medicine in Sri Lanka with regard to NCD prevention.
The present study aimed to understand the knowledge and practice among key stakeholders of educational institutes as well as in practical settings of indigenous medicine. We conducted in-depth interviews with 6 traditional practitioners (i.e., one Ayurvedic medical doctor at a government teaching hospital, two at a research institute, one from a private clinic in the community, and two from an academic institution), and data were analyzed narratively. We found that traditional medical services in Sri Lanka are implemented with holistic knowledge on health promotion and risk reduction. Moreover, undergraduate and postgraduate curricula have been revised according to current health issues. Research institutions have established collaborative research projects with modern medical sectors. Further follow-up research is required to evaluate the efficacy and efficiency of current challenges faced by indigenous medical services in Sri Lanka.
UK newsprint coverage of the debate about further protective smoke-free laws to reduce second-hand smoke exposure to children in cars
Shona Hilton, CSO/MRC Social and Public Health Sciences Unit. University of Glasgow
Josh Bain, CSO/MRC Social and Public Health Sciences Unit. University of Glasgow
Sheila Duffy, ASH Scotland
Sean Semple, Scottish Centre for Indoor Air Division of Applied Health Sciences, University of Aberdeen
Since 2007 there has been legislation prohibiting smoking in all enclosed public places throughout the UK. In the intervening period interest has grown in considering other policy interventions to further reduce the harmful effects of second-hand smoke (SHS) exposure to children. This study offers the first UK investigation into how the news media are framing the current debate around the harms of SHS exposure to children in cars and what role they may be playing in presenting ideas about the need for further smoke-free laws to protect children.
Methods: Qualitative content analysis was conducted on six UK and three Scottish national newspapers between 1st Jan 2004 to 31st Dec 2013. Findings: Exposure to SHS was increasingly identified as being harmful to the health of children, with cars being described as one of the main places of exposure for children following the smoke-free laws. Legislative action was deemed necessary, as well as enforceable, and growing public support highlighted a change in public attitudes towards smoking and willingness for further legislation on SHS to protect children. There were a wide range of advocates in comparison to a narrow number of critics.
Conclusions: Over a decade there was increased reporting on the harms of SHS exposure to children while traveling in cars. This may indicate that there is growing public and policy appetite for further smoke-free legislation to protect children. Previous private vehicle laws suggest that further smoke-free legislation could be successful. Advocates would do well to consider whether there are current opportunities for playing a greater role in the wider debate surrounding the harms of SHS exposure to children in cars.
Navigating Identity using Narratives
Frances Kalu, University of Calgary
The question ‘Where do you come from?’ is frequently asked in Canada usually when the other person, does not fit phenotypically into the dominant culture. Questions around our place of origin challenge our identity, which might lead to insecurity and a sense of not quite belonging. Do questions around identity affect the integration of second generation minority youths in Canada? My proposed research study would explore new directions, using the narrative research framework it will investigate different ways in which second generation minority Canadian youths navigate the identity formation process, as well as develop a sense of belonging and acceptance within the larger mainstream society. It will also seek to identify whether and how the school curriculum supports their integration.
Narratives are ways in which we retell our experiences through stories. These experiences shape our identities and being able to link our experiences through stories help us interpret what they mean. Through the stories told by second generation minority youths in Alberta, I hope to create an understanding of how their experiences shape their identity. Results would increase the knowledge around the integration of second generation minority youths and provide nuanced knowledge on how support available in schools can be improved.
Mixed Methods Developmental Evaluation of an Online Modular WellnessRx Education Initiative
Katharina Kovacs Burns, University of Alberta
Leah Gramlich, University of Alberta
Linda McCargar, University of Alberta
Lana Bistritz, University of Alberta
Melita Avdagovska, University of Alberta Karin Olson, University of Alberta
WellnessRx is an interdisciplinary/interprofessional health initiative focused on nutrition and physical activity as key aspects of wellness. The initiative has three components - education, knowledge translation and community engagement - which are integrated for optimal initiative development, promotion, delivery, and evaluation. A 2009 study conducted jointly between Alberta Health Services (AHS) and the University of Alberta (UA) Health Sciences Council found that the knowledge, skills and attitudes of health professional students and practitioners to foster self-health as well as to advise patients/clients about nutrition, physical activity and wellness were inconsistent or lacking. Responding to this identified need, UA researchers along with AHS staff consulted on and developed a five module online WellnessRx curriculum focusing on the nutrition and physical activity aspects of wellness, and applied knowledge, skills and tools for health professional students and practitioners. The intent here is to describe the methodology and results of a developmental evaluation of two of five modules on Self-Health and Nutrition across the Lifecycle, within two Faculties (Medicine and Nursing). A mixed methods approach with surveys and interviews/focus groups provided a thorough investigation of the curriculum (online format, objectives and content, and resources) and student and instructor experiences. Students said they valued the course content, resources and tools, but had suggestions for changes. Instructors felt positive about the pilot but acknowledged students' complaints and suggested changes. The main issues were that ‘the modules took more time to complete than expected’, and that the modules should be integrated into the curriculum, rather than add-ons.
What now, he's stuck under the table?’ An ethnographic study of graduates successes and challenges for B. Ed. program development
Verna McDonald, University of Northern British Columbia
This research has two parts. The first part invited 70 UNBC, B. Ed. graduates to describe successes and limitations, particularly with indigenous students, as they are sometimes 90% of our school population. Teaching contracts vary from full time single grade classrooms, to language and culture rotational teaching; and from rural band schools, to city private schools.
This second part, has the purpose of using 1) graduate and 2) faculty data to inform B. Ed. curriculum and planning. The research questions to faculty are: 1) What do you think our graduates describe as limitations and successes, with indigenous students particularly? 2) What does this mean for curricular and program development? Ethnographic methodology (Spradley, 1979) explicates cultural dynamics through participants? stories, allowing change in an era of increasing political pressure for economic and educational status quo versus authentic pluralism (Koshy, 2010). Participants include sessional and full time faculty.
Data analysis will: a) use critical realism (Clark, 2012) in examining what works in classrooms as socially constructed; b) build from an epistemological perspective of ?two-eyed seeing? (Battiste, 2010), and c) use indigenous axiology focused on student success - part of changing a whole cross cultural and historic context (Smith, 2006). Stringer (1996) sees mobilizing community as ‘a search for meaning’ where ‘each participant's taken-for-granted cultural viewpoint is challenged and modified so that new systems of meaning emerge’ (p. 158). Improving our academic program means ‘people have accepted the collective responsibility of improving their own workplace practices for social benefit’ (McNiff, 2002, p. 61).
Is art data? Lessons from a CBPR project with the ‘Namgis First Nation people
Gladys McPherson, University of British Columbia
Helen Brown University of British Columbia
Vera Newman, ‘Namgis First Nation
Barb Cranmer, ‘Namgis First Nation
Art, in its many forms, draws us beyond the cognitive and into other realms of human experience. Art teaches us, not only in its completed forms and products, but in the processes of creation. In this Pecha Kucha presentation, we highlight the role of art and art creation within a program of community-based participatory research with the ‘Namgis First Nation people of Alert Bay, British Columbia. Drawing on the specific example of ‘Namgis regalia, we illustrate how traditional button-blanket making engages community members in an art-ful experience of connection and ceremony. It is in this regalia that ‘Namgis people ‘dance their history’. We illustrate how this art form contributes to project goals of enhanced cultural continuity, community social capital and health promotion within this community. We suggest that efforts to represent these activities as data depend, at least in part, on beliefs about art and its role in human experience.
Conducting Qualitative Research among Women Under/Never screened for breast cancer: Partnerships, challenges and Lessons Learned
Victoria Nadalin, Cancer Care Ontario
Julie Maher, Ontario Women's Health Network
Cristina Lessels, Ontario Women's Health Network
To lend insight and practical guidance to quantitative health researchers on issues that arise when conducting community based participatory action research. Breast cancer screening with mammography has known benefits. Many women, eligible for organized programs have never been screened, or are screened less than recommended. Because groups of women more likely to be under-/never-screened include those marginalized in some way, and to minimize the effect of academic researchers on data collection, participatory action research presents an intriguing approach. Describes lessons learned by quantitative health researchers in conducting qualitative inquiry into breast cancer screening knowledge, barriers and recommendations for improvement among women under-/never screened for breast cancer, in partnership with a health promotion agency that conducts qualitative research. Peer researchers were hired and trained by three partner agencies in northern/rural, suburban and inner city regions of Ontario to lead focus groups (three in each region) with a total of seventy-four women. Lessons learned relate to: 1) relationship building and decision making, 2) ownership of data, 3) ethics review and the development of materials, 4) employment of data collection and analysis methods, and 5) knowledge translation. Important elements include early involvement of peer researchers in the process, the need to modify research methods to suit the requirements of the funding agency and a university Research Ethics Board, the importance of establishing trust, and the requirement of more time for informed consent and written background questionnaire. Quantitative-qualitative research partnerships require flexibility, the development of trust, and clear and open communication on neutral ground.
What Is It Like To Be A Child With Type 1 Diabetes Mellitus
Lucila Castanheira Nascimento, University of São Paulo, Ribeirão Preto College of Nursing, Brasil
Valéria de Cássia Sparapani, University of São Paulo, Ribeirão Preto College of Nursing, Brasil
Eufemia Jacob, University of California, Los Angeles, School of Nursing, United States
Diabetes is a complex disease that requires significant changes in lifestyle upon diagnosis, which may be difficult for children because of differences in growth and developmental levels. The purpose of this study was to increase our understanding of “what it is like” to be a child with type 1 diabetes mellitus and explore factors that interfere with disease management. Qualitative interviews using puppets constructed by children, ages 7–12 years, were conducted during clinic visits. The interviewer engaged in conversations to examine thoughts, feelings, and daily experiences with management of diabetes. Results indicated that children (n=19) expressed emotions and psychosocial factors that may interfere with their ability to manage diabetes. These included conflicting desires, insecurity, fear, pain, inadequate knowledge, worry about long term effects, prejudice, rejection, and shame. Findings suggest that during patient teaching at time of diagnoses and follow-up clinic visits, clinicians address not only the physical aspects of the disease (blood sugar monitoring, insulin administration, diet and exercise management) but also examine emotional and psychosocial needs and discuss strategies that will promote positive coping as children live with the complexities of growing up with diabetes.
Resilience and Coping in Liberia Former Girl Child Soldiers
Olive Okraku, University of Alberta
Sophie Yohani, University of Alberta
Ghana is home to about 6,000 Liberian refugees who survived one of Africa's most brutal civil war which ended in 2003 (Omata, 2012). Among these refugees are former child soldiers who fought in the conflict (Verhey, 2001). As part of Africa's more than 120, 00 child soldiers, they wrestle with significant psychological and emotional problems which includes post-traumatic stress, social adjustment difficulties, and reconciliation challenges (Denov, 2010). While existing research has focused on the impact of war on child soldiers, little attention has been paid to their experiences of former girl child soldiers in post conflict environments.
This poster presentation will outline how focused ethnography (Roper & Shapira, 2000) is going to be used to explore refugee coping strategies and resilience in 5 Liberian former girl child soldiers living in a refugee camp in Ghana. Research questions include (a) what are the specific challenges they encounter every day? (b)what are some of the resilience mechanisms they use to facilitate their reintegration into the society? (c) what are some of the coping strategies they use to facilitate their reintegration in a post conflict environment? Data will consist of interviews, observations, and documents. Data analysis will follow Roper and Shapiras' (2000) thematic analysis framework and research rigor will be established using Lincoln and Guba's (1985) criteria of credibility, transferability, confirmability, and dependability. The poster will highlight how ethical considerations such as informed consent and confidentiality will be addressed with this vulnerable population. It is envisaged that this research will have relevance for increasing knowledge and understanding of former girl child soldiers. Furthermore, there is a lack of qualitative research in this area, thereby limiting subjective perspectives and rich descriptive accounts of participants' experiences. First-hand information of the coping experiences of this population of refugees will provide pre-migration perspectives and enhance counselling theories and practice with refugee women.
Why Do Parents Decide Not To Initiate Treatment For Pediatric Obesity?
Arnaldo Perez, University of Alberta
Nicholas L Holt, University of Alberta
Rebecca Gokiert, University of Alberta
Jean-Pierre Chanoine, McMaster University
Laurent Legault, Montreal Children's Hospital
Katherine M Morrison, British Columbia Children's Hospital
Arya M Sharma, University of Alberta
Geoff DC Ball, University of Alberta
Purpose: Many families referred to specialized health services for managing pediatric obesity do not initiate treatment. Reasons for non-initiation are poorly understood. The purpose of our multi-center study was to understand families? reasons for declining tertiary-level health services for managing pediatric obesity.
Method: Interviews were conducted with 18 parents of children (10 to 17 years old; BMI 85th percentile) who were referred for weight management, but did not initiate treatment in one of four Canadian multidisciplinary weight management clinics (Vancouver, BC; Edmonton, AB; Hamilton, ON; Montreal, QC). Parents were asked about a range of topics including the referral, the decision to decline care, challenges faced with initiating treatment, and information about the clinic to which their child was referred. Open-ended and probing questions were used to elicit parents' views of these issues. Interviews were audio recorded and transcribed verbatim. Data were managed using NVivo 9 and analyzed thematically.
Results: Most interviewed parents (mean age: 44.1 years) were female (n=16; 89%), obese (n=11; 63%), and had a university degree (n=13; 71%) Parents? reasons for not initiating health services were grouped into four themes: (i) no perceived need for pediatric weight management (i.e., perceived children did not have a weight or health problem), (ii) no perceived need for further actions (i.e., perceived children had a healthy lifestyle), (iii) no intention to initiate recommended care (i.e., perceived clinical program was not efficacious), and (iv) participation barriers (i.e., time constraints, children's lack of motivation).
Conclusion: Families were at different level of readiness to initiate treatment of pediatric obesity. Our data suggest that initiation of care among physician-referred families may be enhanced by tailoring interventions to families' level of readiness and raising physicians' awareness of available health services that are efficacious for managing pediatric obesity.
Poetry as Epistemology, Approach, and Method in Qualitative Research
Katrina Plamondon, Interior Health & University of British Columbia Okanagan
Poetry is woven in virtually all phases of the research process with vibrancy and diversity. It extends qualitative approaches beyond description or interpretation and toward engagement in research that invites, rather than tells, participants and readers to consider questions or findings. As a means for supporting scholarly reflection on the integrity and credibility in the use of poetry in qualitative research, I sought to understand the extent of its use in qualitative research. In this poster, I will present outcomes of a broad search of the literature that aimed to cast a wide, interdisciplinary net over published peer-reviewed articles. Using EBSCO, I searched for the terms ?qualitative? and ?poet*? in the following databases: Academic Search Complete, Alternative Press Index, Art Full Text, Art Index Retrospective, CINAHL, Communication & Mass Media Complete, Education Research Complete, ERIC, and Women?s Studies International. Limiting the results to peer-reviewed articles in English resulted in 522 matches. Matches were screened, including peer-reviewed articles that discussed the use of poetry in some phase of the research process peer-reviewed. Publications about poetry as the primary subject of research (e.g., poetry as therapy; literary, linguistic, biographical or other literature-related studies; or poetry used in non-research processes) were excluded. After screening, 213 articles remained.
These articles were categorized, using phases of the research process as themes under which articles could be considered. Articles were then reviewed with the intent to describe how poetry was integrated in the research process and/or what methodological considerations and debates were presented under each theme. Poetry was found in use across multiple phases of the research process and as a reflective tool for praxis, supporting researchers in their reflexivity and in the development of their craft. The poster will provide descriptive findings of this high-level review. Reflections on the evolution of the use of poetry in qualitative research and comments on emerging and promising directions for poetry as an arts-informed method, approach, and epistemology in qualitative research will also be highlighted.
Seizing the Moment: The Experiences of School Nurses Caring for Children with Overweight and Obesity
Shannon Powell, East Carolina University
The incidence of childhood overweight and obesity has been recognized as a serious problem in the United States with the rates for overweight and obesity having tripled among children and adolescents over the past 3 decades. Obesity rates are higher among disadvantaged groups including those with low incomes and among minority populations. It is recognized that while children spend a large amount of time in the school setting, schools are a likely place for successful intervention. School nurses are well positioned to assess, intervene, and evaluate efforts to positively impact this population. The purpose of this qualitative, phenomenological pilot study was to explore the experiences of school nurses in providing care to children living with overweight and obesity. Providing care was generally defined as school nurse practices for children with overweight or obesity in the school setting. Data was collected through face-to-face, tape-recorded, in-depth, open-ended interviews with three school nurses from rural areas of North Carolina working with minority and low income children in the public school setting. The text of the interviews were transcribed and analyzed into codes, categories, and themes. One overall theme emerged with three subthemes. The overall theme is described as: School nurses have a “seize the moment” approach to childhood overweight and obesity practices in the school setting. The subthemes included: (1) Lack of time due to resources and other priorities was an overwhelming factor that influenced practices in the school setting. (2) The academic priority as a time barrier within the school setting. (3) Concerns of access to care within the community. The findings of this study provide a beginning understanding into the experiences of school nurses practices for children with overweight and obesity. The experiences of these three participants suggest that limited time, resources, and barriers may prevent increased obesity practices. Studies should be done to further explore these themes in relation to school based interventions.
Childhood Obesity, School Nurse, Experiences, School Nurse Practice
An interpretive description study of security management professionals in online communities
Tony Ratcliffe, University of Leicester
This interpretive description study (in progress) investigates how security management professionals use online communities for work-related learning. Responsible for protecting organizational assets, security management professionals' concerns include local, national, and international issues. As a lone practitioner or team member, the security professional often relies on external sources for work-related learning.
In the exploratory phase, 67 participants in 17 countries completed an online questionnaire, with 10 interviewed using Skype and telephone. The main study features 18 individual and 1 dyadic interviews. Study participants represent Canada, the United Kingdom, and the United States of America, with one from a small European country (not identified to protect anonymity). They represent age groups of 34 to 44 (n=3, 15%), 45 to 54 (n=7, 35%), 55 to 64 (n=6, 30%), and over 65 years of age (n=4, 20%). The theoretical framework encompasses adult learning theory, particularly informal and self-directed learning.
Study participants identified reasons for their community activities and lack of activity. Little evidence supports the notion of building communities of practice; rather, it is more demonstrative of online affinity spaces. Resources are consumed with little collaboration, and there is minimal identification of digital literacy skills. They can be discerning when accessing significant global resources for security, privacy, and authenticity. LinkedIn is the preferred online service for networking, but participant experience suggests that Massive Open Online Courses (MOOCs) offer more focused discussions. Initial conceptualizations from all study participants will be shared with each of them for their critical consideration. New interviews will occur as required.
Facilitators and Barriers to Interprofessional Teamwork within Family Medicine Practices: Physicians' Perspectives
Neil Bell, MD, MSc, FCFP, Department of Family Medicine, University of Alberta
Olga Szafran, MHSA, Department of Family Medicine, University of Alberta
Sandra Robertson, BScN, MN, Misericordia Family Medicine Centre
Beverly Williams, PhD, RN, Faculty of Nursing, University of Alberta
Interprofessional teams were developed to strengthen and improve primary health care and public access to family physicians and other frontline health care providers in Alberta. We have limited knowledge of the complexities and processes of interprofessional teams in primary care environments and what facilitators and barriers might influence effective teamwork.
This study will explore the facilitators and barriers to inter-professional health teams within family medicine practices that are part of Primary Care Networks (PCNs). PCNs have been developed to strengthen delivery of primary care services, such as chronic disease management. PCNs are comprised of physicians, nurses, dietitians, pharmacists, and other allied health care professionals. There are currently 40 PCNs operating in the Province of Alberta, with 79% of all family physicians part of a PCN.
However, we lack an understanding of how teams are developed within PCNS, how they operate and what factors influence how these teams work. In addition, many factors can affect team working in the primary care setting, such as organizational structure, team structure and team characteristics. The study design will use a grounded theory methodology that involves a data collection strategy of face-to-face semi-structured interviews with family physicians. This study complements a previous study from the nursing perspective. The results of this study will be a useful resource in guiding policy, organizations and practitioners in the development and maintenance of effective inter-professional teamwork within primary care settings in Alberta.
Parent's, Teacher's and Student's Perceptions of Childhood Obesity in the Middle East
Kelly Stott, Kean University
Dr. Ray Marks, Teachers College, Columbia Unviersity
The problem of overweight and obese children now constitutes a global epidemic, with high prevalence rates now being reported in many transitional societies. Half of the adults in the United Arab Emirates-one of the wealthiest advanced economies in the world-are overweight or obese and school-age children have experienced a marked increase in BMI. UAE children are 1.8 times more obese than those in the United States and, by age 18, obesity is approximately three times greater among UAE males than those in other countries. This project sought to identify the barriers that prevent UAE children from engaging in physical activity and healthy diets.
We conducted face-to-face interviews with 57 participants living in the greater Ras Al Khaimah area of the UAE, along with observations and field notes, regarding perceptions about childhood overweight and obesity. Interview data were analyzed using qualitative and thematic methods.
Physical inactivity and consumption of fast food and sugared beverages are perceived to contribute to the increase in obesity among UAE children. Social, cultural, and environmental barriers contribute to prevention of childhood obesity in RAK. These include: climate, gender bias, cultural attire, availability and accessibility of resources, technology, and lack of role models. Respondents recognize the problem of childhood obesity in their community and are eager to take part in promoting health awareness and other initiatives that address barriers and have the potential to help school-age children make healthy lifestyle choices.
Teachers, parents, and students in the UAE recognize that being overweight or obese is a serious problem and acknowledge the need for changes in lifestyle in order to prevent the epidemic from continuing to rise. The UAE experience can help us to understand how overweight and obesity influence the health status of children in this and other transitional societies.
The Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD): Improving Donation-Related Attitudes, Knowledge and Behaviors
Heather Traino, Virginia Commonwealth University
Laura Siminoff, Temple University
As the individuals responsible for the identification and referral of potential organ donor-eligible patients to regional Organ Procurement Organizations, healthcare providers (HCP) are the front line of the organ donation process. The constellation of HCP knowledge, attitudes and behaviors has demonstrable impact on the rates of time-sensitive referrals, family authorization of donation, and the recovery of solid organs for transplantation. This qualitative study tested the Rapid Assessment of Hospital Procurement Barriers in Donation?s (RAPiD) utility as a continuous quality improvement (CQI) tool to identify assets for and barriers to donation within hospital environments and improve HCPs' donation-related knowledge, attitudes and behaviors. Using anthropological techniques (e.g., direct observation and a focused ethnographic strategy), we conducted pre-assessments of the donation environments of a national sample of 77 hospitals, the results of which were detailed in report cards enumerating the assets or facilitators of donation-related activities and barriers or impediments to the donation process as well as recommendations for improving donation outcomes at each hospital. Post-assessments were carried out a year later in 68 hospitals. A total of 5,557 HCPs were interviewed during the assessments - 2,552 pre- and 3,005 post-assessment. Observational and interview data were coded to gauge HCP knowledge (9 coding categories), attitudes (6 coding categories) and behaviors (6 coding categories) regarding donor-eligible patient identification and referral. Chi-square tests comparing each of 21 coded variables pre-and post-assessment revealed significant improvements in HCP knowledge, attitudes and behaviors. The RAPiD proved a useful CQI tool for improving hospitals? organ donation culture.
Qualitative Research Leading to Social Action
Barbara Kawulich, University of West Georgia
Mary Alice Varga, University of West Georgia
Different research designs and approaches address different research questions – quantitative research (QR) describes, tests, makes inferences; qualitative research describes, explores, and identifies. Neither proposes to effect change. Patton (2002) suggests that applied research is conducted to enable us to intervene and improve our world. In this paper, we explore two basic QR studies that have become applied QR studies over time. In the first study of students' experiences of grief, the researcher realized that the act of interviewing itself served as a cathartic experience for participants as they retold their stories of losing someone dear. It also shed light on the need for supporting these students. In the second study of Native American women veteran's experience of military service, the researcher found that the participants' service had never been acknowledged nor had they ever been thanked for serving their country. In a third study of Native American women's leadership, a group of the participants subsequently created an ongoing leadership summit for women in the tribe.
In these instances, what began as basic QR evolved into research that effects change in how the participants viewed themselves, their lived experience, and their roles.
Poster Presentation Feeling that the body has changed: the experience of women in the postpartum period
Erika de Sá Vieira Abuchaim, Paulista School of Nursing / Federal University of São Paulo
Isilia Aparecida Silva, School of Nursing / University of São Paulo
Ana Cristina Freitas de Vilhena Abr?o, Paulista School of Nursing / Federal University of São Paulo
The birth of a child triggers in a woman's life a biopsychosocial revolution. Thus, seeking to understand the conscious meaning of the interface of sexuality and breastfeeding for women who experience this process and to understand the manner in which this dimension attributed to the meaning of the interface of sexuality and breastfeeding manifested in the forms of action for women in relation to breastfeeding or sexuality, the theoretical model, Weighing Risks and Benefits was adopted as guiding principle. Symbolic Interactionism and Grounded Theory were used, respectively, as theoretical and methodological frameworks for data analysis of 13 interviews conducted with women living in São Paulo / Brazil, who were or had previously breastfed. Feeling that the body has changed is one of the three phenomena developed and, revealed that the postpartum woman feels differently, perceives that her body changed; it is not the same as it was before pregnancy. Not recognizing this seemingly foreign body, she feels uneasy and confused, as if she expected that, with the birth of the baby, her body would return to the pre-pregnancy state immediately. The change in her body image can be perceived as expected, transient and normal for anyone who has just given birth, however, it provokes her discontent, dissatisfaction and, for some women, interferes with their sexuality, more explicitly the sexual exercise. Believing they need to take care, women seek strategies to return to normal weight and improve their appearance; resulting in feelings of improved self-image and more disposition and confidence in sexual intercourse.