Nursing Graduate and Postdoctoral Student Publications

Permanent URI for this collectionhttps://hdl.handle.net/10222/79475

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Now showing 1 - 20 of 31

Open Access
Youth and caregiver perspectives of barriers and facilitators to the transition from pediatric to adult care: A qualitative descriptive study (Preprint)
(2022) Cassidy, Christine; Kontak, Julia; Higgins, Amanda; Pidduck, Jacklynn; Gallant, Sarah Madeline; Anderson, Scott; Best, Shauna; Jeffers, Elizabeth; MacDonald, Sarah; Mackinnon, Lindsay; Mireault, Amy; Rowe, Liam; Walls, Rose; Daman, Ripu; Drake, Emily K.; Curran, Janet
Background: The transition from pediatric to adult care can be complex for youth and their caregivers. The transition emphasizes personal responsibility for health care management, which can be challenging for youth and caregivers to navigate. Exploring barriers and facilitators is critical to inform the design and implementation of evidence-based interventions to improve the pediatric to adult transition of care. As such, the purpose of this study was to explore the transition of care from the perspective of youth and their caregivers. Methods: We used a qualitative descriptive design guided by the COM-B Model of Behaviour to conduct semi-structured interviews. The COM-B model was used first for directed content analysis, then data were further examined using inductive thematic analysis to identify barriers and facilitators. Results: Eighteen youths and caregivers participated in this study. The findings highlight barriers and facilitators to the transition in care from the pediatric to the adult system from the perspective of both youth and caregivers. Conclusion: Using the COM-B Model of Behaviour, we identified key barriers and facilitators that intersect to influence the transition of care. Findings will be instrumental in informing and adapting initiatives and interventions in to improve the transition from pediatric to adult care.
Open Access
Integrated knowledge translation guidelines for trainees in health research: An environmental scan (Preprint)
(2022) Gallant, Sarah Madeline; Al-Rassi, Joyce; Moody, Elaine; Shin, Hwayeon Danielle; Best, Shauna; Steenbeek, Audrey; Cassidy, Christine
Background: Collaborative health research, such as integrated knowledge translation (IKT), requires researchers to have specific knowledge and skills in working in partnership with knowledge users. Graduate students are often not provided with the opportunity to learn skills in how to establish collaborative relationships with knowledge users in the health system or communities, despite its importance in research. The objective of this environmental scan is to identify available guidelines for graduate trainees to use an IKT approach in their research. Methods: We conducted an environmental scan with three separate systematic searches to identify guidelines available to support graduate students in engaging in an IKT approach to research: i) a customized Google search; ii) a targeted university website search of Canadian universities; and iii) emails to administrators of graduate studies programs asking for available guidelines and documents designed for graduate students. Data were extracted using a standardized data extraction tool and analyzed using a directed content analysis approach. Due to the minimal results included based on the a priori eligibility criteria, we returned to the excluded records to further review the current state of the environment on trainee support for IKT research. Results: Our search strategy yielded 22,900 items, and three documents met the eligibility criteria. All three documents highlighted the need for a concrete IKT plan to facilitate the success and sustainability of knowledge user involvement throughout the research process. There was an emphasis of having steps outlined to support graduate students to ensure successful communication with knowledge users from project inception through to dissemination. Due to the lack of identified resources, we conducted a thematic analysis of excluded resources and identified five themes demonstrating increased education and engagement in an IKT approach at an interpersonal and organizational level. Conclusion: We identified three documents providing guidance to trainees using an IKT approach in their health research. This scan highlighted two key findings, including the importance of empowering knowledge user engagement with trainees and preparing an IKT plan alongside a research plan. Further research is needed to co-design guidelines to support graduate students and trainees in engaging in an IKT approach.
Open Access
Implementation and evaluation of the Eat, Sleep, Console Model of Care for babies diagnosed with neonatal abstinence syndrome: A Scoping Review Protocol (Preprint)
(2022) Gallant, Sarah Madeline; Macneil, Morgan; Al-Rassi, Joyce; Mann, Cynthia; Falconer, Allyson; Mcleod, Rebecca; Aston, Megan; Cassidy, Christine
Introduction: Infants diagnosed with neonatal abstinence syndrome [NAS] or neonatal opioid withdrawal syndrome [NOWS] is a growing population in Canada. In most facilities, an outdated model of care is used to guide the care and assessment of babies diagnosed with NAS. Challenges with this outdated model have prompted the transition to a novel approach to care. Despite this promising intervention to improve patient and health system outcomes, little is known on how to effectively implement and evaluate the model in clinical practice. Objectives: We will conduct a scoping review to address the question, “How has the ESC model been implemented and evaluated in practice?”. Methods: We will follow the Joanna Briggs Institute Methodology for Scoping Reviews and Arksey and O’Malley’s scoping review framework. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews. Published and unpublished literature will be included in the review. The following databases and grey literature will be searched: MEDLINE, Embase, CINAHL, PsycINFO, Google Scholar, and websites identified in a google website search. Two independent reviewers will screen, and extract data based on pre-determined eligibility criteria and data extraction tools. We will narratively describe quantitative data, along with completing an inductive thematic analysis of qualitative findings. Furthermore, we will conduct a directed content analysis of qualitative findings using the COM-B Model of Behaviour and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) Framework. We anticipate findings will be used to support future implementation and evaluation of the ESC model into clinical practice.
Open Access
Addressing Gaps in Knowledge for Infants with Neonatal Abstinence Syndrome: A literature review (Preprint)
(2022) Gallant, Sarah Madeline; Cassidy, Christine; Breneol, Sydney; Somerville, Mari
Neonatal abstinence syndrome is a growing epidemic worldwide. Infants diagnosed with neonatal abstinence syndrome require extensive medical care and are at risk for complex health conditions. This literature review aims to identify current knowledge gaps in nursing practice in caring for infants diagnosed with NAS and their families. This review aimed to identify and synthesize current best practice guidelines for infants with neonatal abstinence syndrome. A comprehensive search strategy was developed, and four scholarly databases (CINAHL, PubMed, Cochrane and Google Scholar) were searched. Additional articles were identified through hand searching the reference lists of key articles. Relevant articles were critically analyzed for their implications on infant and family health, family experience, health system outcomes, and nursing practice. This literature review revealed the Eat, Sleep, Console model of care is optimal but is not widely used in practice. Further efforts are needed to support the real-world implementation of evidence-based models of care for this population.
Open Access
Mother-Child Programs for Incarcerated Mothers and Children and Associated Health Outcomes: A Scoping Review
(Longwoods, 2020-03) Paynter, Martha; Jefferies, Keisha; McKibbon, Shelley; Martin-Misener, Ruth; Iftene, Adelina; Tomblin Murphy, Gail
Background: Increasing incarceration of women disrupts fertility, family formation, parenting and mother-child relationships. It is common in many jurisdictions, including Canada, to mitigate the harm of separation from the primary parent through programs allowing children to co-reside with their mothers in prison. In this scoping review, we asked the following questions: (1) What are the characteristics of residential mother-child programs in carceral facilities? (2) Who is eligible to participate? (3) How do these programs make a difference to maternal and child health outcomes? Method: We use the Joanna Briggs Institute methodology for systematic scoping reviews. This approach includes a three-step search strategy developed with a clinical research librarian. Databases searched include MEDLINE, CINAHL, PsycINFO, Gender Studies Abstracts, Google Scholar and ProQuest Dissertations. The search yielded 1,499 titles and abstracts, of which 27 met the criteria for inclusion. Results: Conducted from 1989 to 2019, across 12 countries, the studies included qualitative and quantitative methods. None was based in Canada. The most common outcomes among the studies included attachment, development, infection, neonatal outcomes, mental health, pregnancy and general experiences. Discussion: Although supporting attachment, mother-child program participation is complex and challenging. High morbidity in the incarcerated population and lack of data collection before and after program participation prevent conclusions, and wide variations in contexts prevent comparisons. Benefits: This scoping review illustrates the complexity of maternal and child health outcomes associated with mother-child programs. Initiation or continuation of or changes to such programs must be made with careful consideration.
Open Access
Gender and the Privatization of Public Responsibility for Vaccination
(University of Toronto Press, 2022) Paynter, Martha
Open Access
Atlantic Canada Needs a Human Milk Bank.
(SAGE, 2017-10-16) Paynter, Martha
Open Access
Breastfeeding Support for Criminalized Women in Canada
(SAGE, 2017-08-18) Paynter, Martha; Snelgrove-Clarke, Erna
Open Access
Medicine, Body Fluid and Food: The Regulation of Human Donor Milk in Canada.
(Longwoods, 2018-02) Paynter, Martha; Hayward, Kathryn
The use of peer-to-peer online networks to access both pasteurized and unpasteurized human donor milk is increasing in Canada. In the absence of a mother's own milk, donor milk is the next best nutrition available for all infants in need of supplementation. Limited supply and the cost of pasteurized milk puts it out of reach for many. Although milk banks in Canada all operate on a non-profit basis, there is a lack of regulatory safeguards regarding for-profit operations and private milk exchange. This paper describes regulation of human donor milk and identifies gaps putting families at risk.
Open Access
Policy and Legal Protection for Breastfeeding and Incarcerated Women in Canada
(SAGE, 2018-03-27) Paynter, Martha
Most incarcerated women in Canada are mothers. Because women are the fastest growing population in carceral facilities, protecting the rights of incarcerated women to breastfeed their children is increasingly important. There is considerable evidence that incarcerated women in Canada experience poor physical and mental health, isolation, and barriers to care. Incarcerated women and their children could benefit significantly from breastfeeding. This Insight in Policy explores policy and legal protection for breastfeeding in Canada as it relates to carceral facilities, considers key cases regarding breastfeeding rights among incarcerated women, and presents recommendations for policy development and advocacy. The Canadian Constitution and human rights legislation across Canada prohibits discrimination on the basis of gender and includes pregnancy and the possibility of becoming pregnant as a characteristic of gender. Some provinces note that breastfeeding is a characteristic of gender. Women’s Wellness Within, a nonprofit organization providing volunteer perinatal support to criminalized women in Nova Scotia, conducted a scan of all provincial and territorial correctional services acts and the federal Corrections and Conditional Release Act: none mention breastfeeding. Protocols for breastfeeding during arrest and lockup by police were not available in any jurisdiction across Canada. International law, including the Convention on the Rights of the Child, the Nelson Mandela Rules, and the Bangkok Rules, have application to the rights of incarcerated breastfeeding women. The Inglis v. British Columbia (Minister of Public Safety) (2013) and Hidalgo v. New Mexico Department of Corrections (2017) decisions are pivotal examples of successful litigation brought forward by incarcerated mothers to advance breastfeeding rights. Improved application and understanding of existent law could advance breastfeeding rights.
Open Access
Nursing Students Respond to Opioid Crisis with Naloxone Education
(Canadian Science Publishing, 2018-11-19) Paynter, Martha; Richardson, Brianna
This report describes how graduate students in nursing education have developed capacity among student nurses in response to the opioid crisis in Canada by using education on harm reduction practice and naloxone administration.
Open Access
The Intergenerational Impact of Management Relations on Nurse Career Satisfaction and Patient Care
(Wolters Kluwer, 2018-12) Price, Sheri L.; Paynter, Martha; Hall, Linda McGillis; Reichert, Carol
Objective This article provides insights into the role of management relations on nurses’ career satisfaction across different career stages. Background Managers and positive relations with staff are critical to improving job satisfaction, career development, and retention for new graduates to mid- to late-career nurses. Methods Using a descriptive qualitative approach, we conducted a thematic analysis of 18 focus groups held in 8 Canadian provinces with 185 student, early-career, and mid- to late-career nurse participants. Results Student participants expressed the need for a supportive environment to enable successful transition to practice. Early-career nurses expected effective leadership at the unit level, effective communication, and positive working relationships to enable best care outcomes. Mid- to late-career nurses were most dissatisfied with management interactions and relationships. Conclusions Management relations are important across all career stages, affecting patient care and job satisfaction. Findings provide insight into how nurse-manager relations can be enhanced from new graduate support to guidance in career development and ongoing recognition and respect for nurses throughout their careers.
Open Access
A critical review of human milk sharing using an intersectional feminist framework: Implications for practice
(Elsevier, 2018-11) Paynter, Martha; Goldberg, Lisa
Objective Driven by a growing body of research demonstrating the health benefits of human milk over substitute feeding preparations, the demand for human milk donations in North America is rapidly increasing. In the context of an increasingly institutionalized and commercialized human milk market, informal peer-to-peer milk sharing networks are commonplace. Race, class, gender and sexual orientation are intersecting aspects of identity and power that influence participation in breastfeeding and the domain of milk exchange. Using an intersectional feminist framework, we critically review studies of participation in milk sharing to examine the identities and socio-political circumstances of milk sharing participants. Design, Setting and Participants We use an intersectional feminist framework to conduct a critical review of the evidence pertaining to human milk sharing participants in North America. The search strategy included relevant databases (Pubmed, CINAHL) and hand-searches of key journals. We include research studies with participants in the United States and Canada and where participants milk shared as recipients or donors. Findings Of those studies that examine socio-political identities such as race and class, participants are largely white and high-income. Many studies did not examine socio-political identities, and none examine sexual orientation. Themes we identify in this review include: (1) Socio-political identities; (2) Milk sharing supports parental health; (3) Socio-political influences; (4) Resistance against institutionalization. Implications for Practice Maternity care providers can advocate for improved access to breastfeeding support and pasteurized human donor milk to address inequities. Maternity care providers can bring consciousness of intersecting socio-political identities to discussions with families about milk-sharing.
Open Access
The Roosevelt Hospital Banco de Leche: Nonprofit Human Donor Milk Bank in Guatemala City
(SAGE, 2018-10-30) Paynter, Martha; Celis-Hecht Mendoza, Ana Karen
Open Access
Clinical Opinion Letters Regarding Breastfeeding and Neonatal Abstinence Syndrome for Child Apprehension Family Court Proceedings
(SAGE, 2018-12-13) Paynter, Martha
The accelerating reach of opioid use disorder in North America includes increasing prevalence among pregnant people. In Canada, the rate of Neonatal Abstinence Syndrome (NAS) rose 27% between 2012–2013 and 2016–2017, and it is estimated that 0.51% of all infants now experience NAS after delivery. Pregnant people are a priority population for access to opioid replacement therapy programs. Participation in such programs demonstrates significant commitment to self-care among pregnant people and concern for fetal and infant wellbeing. Participation in opioid replacement therapy often results in family surveillance by Child Protection Services and infant apprehension. Children of Indigenous descent are held in foster care at high and disproportionate rates.The Convention on the Rights of the Child principle of Best Interests of the Child governs family law and child access decisions. The value of breastfeeding for all children and in particular for children recovering from NAS can be a consideration in the Best Interest of the Child. Clinicians with expertise in lactation may support the breastfeeding dyad to remain together by preparing Clinical Opinion Letters for the court. This Insights into Policy presents a how-to description of the content of clinical opinion letters in such cases, including context and process considerations, client background, breastfeeding science, and factors specific to neonatal abstinence syndrome.
Open Access
Medication and Facilitation of Transgender Women’s Lactation
(SAGE, 2019-03-06) Paynter, Martha
Open Access
Maternal health outcomes for incarcerated women: A scoping review
(Wiley, 2019-02-20) Paynter, Martha; Drake, Emily K.; Cassidy, Christine; Snelgrove-Clarke, Erna
Aims and objectives To inform a systematic synthesis of what is known about the maternal health outcomes of incarcerated women, this scoping review uses a theoretical framework of intersectional feminism. Background Despite rising imprisonment of women, there is a lack of research, from a feminist perspective, on perinatal health outcomes among incarcerated women. Design Systematic scoping review using the Joanna Briggs Institute scoping review methodology. Methods In consultation with a medical research librarian, key databases and journals were searched for English and French-language articles published up to February 2018. Two authors independently screened titles and abstracts to identify articles for full-text review. Study quality was appraised using the McGill Mixed Methods Appraisal Tool. The study adheres to PRISMA-EQUATOR guidelines. Results Forty-five studies met the preset criteria and were reviewed in full text. In addition, 13 studies met consensus for inclusion. Method, setting, participants, sample, relevant outcomes and relevant findings were extracted from each study for synthesis. Included studies had varied methods and were published from 1989–2014. Participants included women imprisoned during the perinatal period up to six months postpartum. All studies were conducted in carceral contexts, with 12 based in the USA and one in Australia. Outcomes of interest included breastfeeding, operative deliveries, gestational complications, depression, stress, experiences, bonding and sterilisation. Conclusion The research on maternal health outcomes pertaining to incarcerated women is limited. There is a need for in-depth examination of breastfeeding with this population. Researchers need to examine the prevalence and impact of carceral force, such as shackling, solitary confinement, strip-searching and restraints in pregnancy. There is a need for research that asks what health outcomes matter to the women themselves. Relevance to clinical practice Providers must be conscious of intersecting layers of discrimination and trauma incarcerated women experience and its impact on maternal health in the perinatal period and advocate for women.
Open Access
“Breastfeeding in public” for incarcerated women: the baby-friendly steps
(Springer, 2019) Paynter, Martha; Snelgrove-Clarke, Erna
Background: Women are the fastest-growing population in carceral facilities in Canada. Most incarcerated women are mothers, with above-average parity. The incarceration of women has implications not only for women’s health, but for that of their children. For example, how is breastfeeding and access to human milk supported in the context of imprisonment? Both carceral and health services are publicly-funded and administered in Canada. Due in part to the well-documented ill-health burden of imprisoned women, health and carceral functions overlap in the spaces of confinement. This paper discusses “breastfeeding in public” in relation to imprisoned women: separated from the public, yet in publicly-funded spaces under public servant control. With increasing adoption of Baby Friendly Hospital Initiative (BFI) Ten Steps in Canadian health centres, there is a need to consider the health centre spaces precluded from its application and make visible the women and children affected. This paper uses the BFI Steps as a lens to consider the environment of confinement for the breastfeeding incarcerated person. The exclusion of breastfeeding and access to human milk for imprisoned women and children extends the punitive carceral function beyond the experience of incarceration and beyond the experience of the convicted mother. Discussion: Carceral facilities lack breastfeeding policies, foundational to breastfeeding support. Despite high fertility and parity among incarcerated women, carceral health care providers are not required to demonstrate maternity and reproductive health care specialization. The overarching mission of carceral institutions remains security, and support for breastfeeding among incarcerated women is hampered in spaces of conflict, punishment, surveillance and control. A minimal requirement to support exclusive breastfeeding is to promote the mother being with the infant and most incarcerated mothers are separated from their infants. Incarcerated women lack support, information, and community connections for extended breastfeeding beyond six months. Carceral facilities are not welcoming environments for breastfeeding families. Despite the incompatibility of breastfeeding with incarceration, BFI Step 10, coordinating discharge, demonstrates opportunity for improvement through community and health care provider engagement. Conclusion: Incarceration challenges the reach and applicability of the BFI Steps to enhance breastfeeding and to problematize the idea of breastfeeding “in public.”
Open Access
Promoting recruitment by rebranding the image of nursing
(RCN Publishing Company, 2019-09) Price, Sheri L.; MacMillan, Kathleen; Awad, Christine; Paynter, Martha
Understanding the factors that can influence people to pursue a career in nursing is essential for healthcare service managers, human resource professionals and nurse educators, particularly given the global shortage of nurses. There is evidence that the public perception of nursing can be negatively influenced by the media and nursing recruitment advertisements, and that this can discourage some people from choosing nursing as a career. At the Dalhousie University in Canada, evidence regarding the career choices of prospective nurses was used to inform a rebranding strategy for the School of Nursing’s recruitment materials. The aim of the rebranding strategy was to present the School of Nursing as a diverse institution that provided a range of career opportunities for its nursing students. This article describes the background and implementation of the rebranding project. It also details how the university’s evidence-based rebranding strategy was designed to positively influence people to choose nursing as a career.
Open Access
Experiences With Managing the Workplace Social Environment: A Qualitative Study
(Ovid, 2019) Price, Sheri L.; Vine, Jocelyn; Gurnham, Mary Ellen; Paynter, Martha; Leiter, Michael
OBJECTIVE This study aims to examine 1st-line managers' (FLMs') experiences in managing the workplace social environment (WSE). BACKGROUND FLMs are responsible for the establishment and maintenance of supportive WSE essential for effective teamwork. Poorly managed WSE and dysfunctional teams hold negative implications for patients, teams, and organizations. METHODS This was a qualitative descriptive study, using content analysis of individual and focus group interviews with FLMs and directors. RESULTS FLMs play a critical role in the management of the WSE; however, the task is fraught with constraints and challenges including competing demands, lack of support, and insufficient training. Findings explicate how competing demands and communication challenges impede the successful management of the WSE. CONCLUSIONS Given the importance of a healthy WSE to patient, professional, and organizational outcomes, FLMs need support, training, and resources to assist them in managing the social environment alongside other competing priorities.

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