119 results
Search Results
2. Optimization of home care nurses in Canada: A scoping review.
- Author
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Ganann, Rebecca, Weeres, Annette, Lam, Annie, Chung, Harjit, and Valaitis, Ruta
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CINAHL database ,CONTINUUM of care ,HOME nursing ,WORKING hours ,MEDICAL information storage & retrieval systems ,INTERPROFESSIONAL relations ,LEADERSHIP ,MEDICAL care use ,MEDICAL practice ,MEDLINE ,NURSES ,ONLINE information services ,PROFESSIONAL employee training ,TECHNOLOGY ,EMPLOYEES' workload ,SYSTEMATIC reviews ,LITERATURE reviews ,OCCUPATIONAL roles - Abstract
Nurses are among the largest providers of home care services thus optimisation of this workforce can positively influence client outcomes. This scoping review maps existing Canadian literature on factors influencing the optimisation of home care nurses (HCNs). Arskey and O'Malley's five stages for scoping literature reviews were followed. Populations of interest included Registered Nurses, Registered/Licensed Practical Nurses, Registered Nursing Assistants, Advanced Practice Nurses, Nurse Practitioners and Clinical Nurse Specialists. Interventions included any nurse(s), organisational and system interventions focused on optimising home care nursing. Papers were included if published between January 1, 2002 up to May 15, 2015. The review included 127 papers, including 94 studies, 16 descriptive papers, 6 position papers, 4 discussion papers, 3 policy papers, 2 literature reviews and 2 other. Optimisation factors were categorised under seven domains: Continuity of Care/Care; Staffing Mix and Staffing Levels; Professional Development; Quality Practice Environments; Intra‐professional and Inter‐professional and Inter‐sectoral Collaboration; Enhancing Scope of Practice: and, Appropriate Use of Technology. Fragmentation and underfunding of the home care sector and resultant service cuts negatively impact optimisation. Given the fiscal climate, optimising the existing workforce is essential to support effective and efficient care delivery models. Many factors are inter‐related and have synergistic impacts (e.g., recruitment and retention, compensation and benefits, professional development supports, staffing mix and levels, workload management and the use of technology). Quality practice environments facilitate optimal practice by maximixing human resources and supporting workforce stability. Role clarity and leadership supports foster more effective interprofessional team functioning that leverages expertise and enhances patient outcomes. Results inform employers, policy makers and relevant associations regarding barriers and enablers that influence the optimisation of home care nursing in nursing, intra‐ and inter‐professional and inter‐organisational contexts. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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3. Temporal trends in place of death for end‐of‐life patients: Evidence from Toronto, Canada.
- Author
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Sun, Zhuolu, Guerriere, Denise N., Oliveira, Claire, and Coyte, Peter C.
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CONCEPTUAL structures ,DEATH ,HOME care services ,INTERVIEWING ,LONGITUDINAL method ,PALLIATIVE treatment ,QUESTIONNAIRES ,RESEARCH funding ,SURVEYS ,TERMINAL care ,TERMINALLY ill ,LOGISTIC regression analysis ,HOME environment ,PLACE of death ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Understanding the temporal trends in the place of death among patients in receipt of home‐based palliative care can help direct health policies and planning of health resources. This paper aims to assess the temporal trends in place of death and its determinants over the past decade for patients receiving home‐based palliative care. This paper also examines the impact of early referral to home‐based palliative care services on patient's place of death. Survey data collected in a home‐based end‐of‐life care program in Toronto, Canada from 2005 to 2015 were analysed using a multivariate logistic model. The results suggest that the place of death for patients in receipt of home‐based palliative care has changed over time, with more patients dying at home over 2006–2015 when compared to 2005. Also, early referral to home‐based palliative care services may not increase a patient's likelihood of home death. Understanding the temporal shifts of place of death and the associated factors is essential for effective improvements in home‐based palliative care programs and the development of end‐of‐life care policies. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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4. Prevention-enhancing interactions: a Critical Interpretive Synthesis of the evidence about children who sexually abuse other children.
- Author
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McKibbin, Gemma, Humphreys, Cathy, and Hamilton, Bridget
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PREVENTION of child sexual abuse ,CHILD sexual abuse ,CHILD welfare ,COMMUNICATION ,CONCEPTUAL structures ,HEALTH ,PSYCHOLOGY information storage & retrieval systems ,MATHEMATICAL models ,PARENT-child relationships ,PORNOGRAPHY ,POST-traumatic stress disorder ,PUBLIC health ,RESEARCH funding ,SEX offenders ,VICTIMS ,SYSTEMATIC reviews ,SEARCH engines ,THEORY ,BIBLIOGRAPHIC databases ,THEMATIC analysis ,SUICIDAL ideation ,DISEASE prevalence ,META-synthesis ,CHILDREN - Abstract
There is a growing interest in English-speaking jurisdictions, including Australia, North America, Canada, the United Kingdom and New Zealand, about the prevention of sexual abuse perpetrated by children against other children. The aim of this review was to identify opportunities for research, policy and practice which could enhance the prevention agenda relating to the perpetration of sexual abuse by children through conducting a Critical Interpretive Synthesis. Eleven electronic databases were searched in the period from 22 April to 23 May 2013 and included: SocINDEX, Social Services Abstracts, Applied Social Sciences Index and Abstracts, Family and Society Studies Worldwide, Project Muse, PsychINFO, Family and Society Plus, Jstor, Expanded Academic ASAP, Web of Science and Google Scholar. Key individual journals were also searched, including Child Abuse and Neglect and the Journal of Interpersonal Violence, as well as the grey literature. The search was guided by the research question: How could the prevention agenda relating to sexual abuse perpetrated by children be enhanced? The systematic literature search yielded 3323 titles, and 34 of these papers were included in the final synthesis. The authors identified five domains operating in the evidence base: characteristics, causes, communications, interventions and treatments. A synthesising construct emerged from the review: prevention-enhancing interactions. This construct referred to the potential for enhancing the prevention agenda which exists as the evidence domains interact with one another, and with the public health model of prevention. The authors consider this review to be a timely contribution to the current agenda pertaining to sexual abuse perpetrated by children. It provides researchers, policy makers and practitioners in the field with an evidence-informed conceptualisation of opportunities for enhancing prevention work. [ABSTRACT FROM AUTHOR]
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- 2016
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5. Paediatric pandemic planning: children’s perspectives and recommendations.
- Author
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Koller, Donna, Nicholas, David, Gearing, Robin, and Kalfa, Ora
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CHILDREN'S hospitals ,DISASTERS ,PANDEMICS ,SARS disease ,MEDICAL care ,MANAGEMENT - Abstract
Children, as major stakeholders in paediatric hospitals, have remained absent from discussions on important healthcare issues. One critical area where children’s voices have been minimised is in the planning for future pandemics. This paper presents a subset of data from a programme of research which examined various stakeholder experiences of the severe acute respiratory syndrome (SARS) outbreaks of 2003. These data also generated recommendations for future pandemic planning. Specifically, this paper will examine the perspectives and recommendations of children hospitalised during SARS in a large paediatric hospital in Canada. Twenty-one ( n = 21) child and adolescent participants were interviewed from a variety of medical areas including cardiac ( n = 2), critical care ( n = 2), organ transplant ( n = 4), respiratory medicine ( n = 8) and infectious diseases (patients diagnosed with suspected or probable SARS; n = 5). Data analyses exposed a range of children’s experiences associated with the outbreaks as well as recommendations for future pandemic planning. Key recommendations included specific policies and guidelines concerning psychosocial care, infection control, communication strategies and the management of various resources. This paper is guided by a conceptual framework comprised of theories from child development and literature on children’s rights. The authors call for greater youth participation in healthcare decision-making and pandemic planning. [ABSTRACT FROM AUTHOR]
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- 2010
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6. The hopelessness effect: Counsellors' perceptions of their female clients involved in sex work in Canada.
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Magnan‐Tremblay, Laurence, Lanctôt, Nadine, and Couvrette, Amélie
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DESPAIR ,FEAR ,HEALTH ,HOPE ,INTERVIEWING ,RESEARCH methodology ,SEX work ,SAFETY ,HUMAN sexuality ,SOCIAL stigma ,CRIME victims ,WORK environment ,QUALITATIVE research ,CLIENT relations ,SOCIAL support ,PSYCHOTHERAPIST attitudes ,DESCRIPTIVE statistics - Abstract
This qualitative study explored how counsellors who work with women currently or formerly involved in sex work perceive these women's future. From May to July 2016, we conducted semi‐structured interviews with 21 counsellors providing psychosocial services in Canadian agencies with recognized mandates to support such women. The interview protocol was based on the Possible Selves Mapping Interview, adapted to explore the counsellors' hopes and fears for these clients. We subjected the interview transcripts to an interpretive descriptive analysis. Our findings centred on three themes: the counsellors' hopes for their clients' future, in light of their personal and social resources; the counsellors' fears about the cumulative devastating effects that their clients' work environment might have on them; and the counsellors' fears that these women would lose hope for the future. This study clearly demonstrates the importance of addressing the safety and well‐being of women involved in sex work and of recognizing the impacts of social inequalities and structural barriers on these women's life paths. The implications of these findings for policies and practices are discussed at the end of this paper. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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7. How can cities tackle hoarding? Examining an intervention program bringing together fire and health authorities in Vancouver.
- Author
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Kysow, Kate, Bratiotis, Christiana, Lauster, Nathanael, and Woody, Sheila R.
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CHI-squared test ,COMMUNITY health services ,FIRE prevention ,HOME care services ,INTERPROFESSIONAL relations ,RESEARCH methodology ,MEDICAL records ,MEETINGS ,PUBLIC health ,REGRESSION analysis ,T-test (Statistics) ,COMPULSIVE hoarding ,EVALUATION of human services programs ,DESCRIPTIVE statistics ,NURSING interventions - Abstract
Hoarded homes can pose a threat to public safety, with heightened risks of fire hazards, pest infestations and noxious odours in both the home and neighbouring dwellings. Communities across North America are responding to these public safety concerns through a harm reduction approach. This descriptive study explores the implementation and outcomes of the City of Vancouver's approach involving a partnership between fire prevention and public health. Data were collected from the team's 2016–2018 case tracking systems, consisting of health records and team intervention record, as well as notes taken from case briefing meetings. Study objectives included describing the intervention model, providing descriptive statistics on clients and their clutter volume, the interventions undertaken, and exploring predictors of clutter volume and case outcome through exploratory analyses. The sample included 82 cases involving severely hoarded conditions or more moderate hoarding conditions paired with additional client vulnerabilities (e.g. health conditions, frailty). Results from paired samples t‐tests and regression analysis, suggest the Hoarding Action Response Team's (HART) model of a community‐based intervention for hoarding was associated with clutter reduction and tenancy preservation. HART successfully maintained engagement with most clients, and most cases were closed within six home visits. Despite these successes, the team dealt with several barriers including client avoidance and limited resources. This paper provides guidance for communities who are working to develop a coordinated response to problems associated with hoarding and begins to establish expectations for what can be achieved through a community‐based hoarding intervention model. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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8. Exploring employment as a space of respite and resistance for family caregivers.
- Author
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Joseph, Gillian and Joseph, Alun
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TREATMENT of dementia ,FAMILIES & psychology ,PSYCHOLOGY of caregivers ,EMPLOYMENT ,LEISURE ,SERVICES for caregivers ,CASE studies ,RESEARCH funding ,SOCIALIZATION ,QUALITATIVE research - Abstract
This paper challenges traditional definitions of work and leisure as separate concepts by suggesting that a space where individuals engage in employment (paid work) can, at the same time, be a space of respite (leisure) for employees who are also family caregivers. The research aims to better understand what caregivers perceive as ideal respite space, what that space means to them, how the space where employment takes place fits that ideal and what forces restrict caregivers' ability to engage with employment as a space of respite. The term space is used because a caregiver's presence in a particular space (inside or outside of a place) gives it meaning that is simultaneously social, political and emotional. We report on a qualitative intrinsic case study of primary caregivers who are both employed and providing care to relatives with dementia. Using a reflective iterative process, 12 participants were recruited and interviewed from two Canadian provinces in 2013/14. Using a non‐temporal view of respite facilitated the identification of employment as an important space for caregivers to experience effective respite. Although this connection has been noted by other scholars, our research goes beyond this to identify four forces that create challenges for caregivers who want to maintain engagement with employment as a space of respite. These forces are internalised socialisation, family and organisational pressures and government policy. In addition, this research is one of the first to suggest ways that caregivers resist these forces. In concluding remarks, we reflect on the limitations of the study and offer suggestions for further research aimed at elucidating the spatiality of caregiver respite and the complex and dynamic aspects of resistance. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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9. Impacts of care-giving and sources of support: a comparison of end-of-life and non-end-of-life caregivers in Canada.
- Author
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Williams, Allison M., Wang, Li, and Kitchen, Peter
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PSYCHOLOGY of caregivers ,CHI-squared test ,CONFIDENCE intervals ,ECONOMICS ,EMPLOYMENT ,FACTOR analysis ,FAMILIES ,INTERVIEWING ,SERVICES for caregivers ,EVALUATION of medical care ,QUALITY of life ,RESEARCH funding ,TERMINAL care ,LOGISTIC regression analysis ,SOCIOECONOMIC factors ,BURDEN of care ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
This is the second in a series of papers that deal with care-giving in Canada, as based on data available from the Canadian General Social Survey (2007). Building on the first paper, which reviewed the differences between short-term, long-term and end-of-life ( EOL) caregivers, this paper uniquely examines the caregiver supports employed by EOL caregivers when compared to non- EOL caregivers (short-term and long-term caregivers combined). Both papers employ data from Statistics Canada's General Social Survey ( GSS Cycle 21: 2007). The GSS includes three modules, where respondents were asked questions about the unpaid home care assistance that they had provided in the last 12 months to someone at EOL or with either a long-term health condition or a physical limitation. The objective of this research paper was to investigate the link between the impact of the care-giving experience and the caregiver supports received, while also examining the differences in these across EOL and non- EOL caregivers. By way of factor analysis and regression modelling, we examine differences between two types of caregivers: (i) EOL and (ii) non- EOL caregivers. The study revealed that with respect to socio-demographic characteristics, health outcomes and caregiver supports, EOL caregivers were consistently worse off. This suggests that although all non- EOL caregivers are experiencing negative impacts from their care-giving role, comparatively greater supports are needed for EOL caregivers. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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10. Profiles of Permanent Supportive Housing Residents Related to Their Quality of Life and Community Integration.
- Author
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Fleury, Marie-Josée, L'Espérance, Nadia, Armoon, Bahram, and Skouteris, Helen
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MEDICAL care use ,SUBSTANCE abuse ,SELF-esteem testing ,INDEPENDENT living ,RESEARCH funding ,CLUSTER analysis (Statistics) ,T-test (Statistics) ,SATISFACTION ,PSYCHOLOGICAL distress ,OUTPATIENT services in hospitals ,REHABILITATION ,INTERVIEWING ,FISHER exact test ,MENTAL illness ,SEX distribution ,QUESTIONNAIRES ,PRIMARY health care ,SYMPTOMS ,CHI-squared test ,DESCRIPTIVE statistics ,AGE distribution ,FOSTER home care ,HOSPITAL emergency services ,FUNCTIONAL status ,QUALITY of life ,RESEARCH methodology ,SUICIDE ,HOUSING ,SOCIODEMOGRAPHIC factors ,COMMUNITY services ,SOCIAL support ,PERSONALITY tests ,DATA analysis software ,CONFIDENCE intervals ,PATIENT satisfaction ,HOMELESSNESS ,COMORBIDITY ,EDUCATIONAL attainment ,SELF-perception ,COVID-19 pandemic - Abstract
Permanent supportive housing (PSH) is the main approach advocated in Western countries for eradicating homelessness. Considering that PSH residents are not a homogeneous group and that their quality of life (QoL) and community integration (CI) might differ in this setting, improving our understanding of these residents' profiles may help stakeholders formulate informed recommendations to improve PSH. This study identified PSH resident profiles based on their QoL, CI, and sociodemographic and clinical characteristics and associated these profiles with housing features and service use. A total of 308 PSH residents were recruited in Montreal (Canada) in 2020–2022. Structured interviews were conducted. PSH resident profiles were produced with cluster analysis and subsequently compared using chi‐square, Fisher's, and t‐tests, taking into account housing features and service use. Three PSH resident profiles were found. Profile 1 residents (22% of the sample) had low QoL and CI, were younger, and had major social and health issues and unmet needs. Showing moderate QoL and CI, Profile 2 residents (27%) were more educated, had little foster care history, were older on their first homelessness episode, and had few co‐occurring MD‐SUD. Profile 3 residents (51%) had the best QoL and CI and mostly included men with little education, affected by co‐occurring MD‐SUD and satisfied with services. More intensive housing support and care coordination may be recommended for Profile 1 PSH residents in response to their diverse needs. Work integration may be beneficial to Profile 2 residents, with programs such as Individual Placement and Support, along with increased rehabilitation activities. A better integration of MD‐SUD treatments may be promoted for Profile 3 residents. Considering most PSH residents had multiple health issues and unmet needs, satisfaction with care could be monitored better, as it was found to be a key variable in measuring care adequation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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11. Problematizing Dominant Assumptions about Unpaid Support through Exploring Case Study Profiles of Older Home Care Clients.
- Author
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Funk, L., Kuryk, K., Spring, L., and Keefe, J.
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HOME care services ,ELDER care ,QUALITATIVE research ,RESEARCH funding ,INTERVIEWING ,SERVICES for caregivers ,LONGITUDINAL method ,RESEARCH methodology ,PSYCHOLOGY of caregivers ,CASE studies - Abstract
Despite efforts to acknowledge diversity among unpaid caregivers, Canadian research, advocacy, practice, and policy tend to be based in and to reproduce dominant social and institutional expectations and assumptions about who provides unpaid support and why, and what this support looks like. The objective of thtudinal, qualitative research study. In that study, qualitative case study interviews were conducted with twelve home care clients, their identified family or friend caregiver, home care aide, case coordinator, and agency supervisor (129 interviews in total). Case study profiles compiled over time generated deeper information about the availability and capacity of informal sources of support for these clients, which prompted abductive analysis in relation to dominant assumptions typically made about caregivers in research, policy, and practice. Specifically, only one case (participant) had a caregiver whose profile closely matched dominant conceptualizations. In the remaining eleven cases, we found situations wherein: (a) caregivers grappled with physical or mental health challenges limiting their participation in care (sometimes meaning the client is themselves a caregiver, or the caregiver is also receiving home care services); (b) caregivers facing burnout sought to delimit their participation in care; (c) caregivers' participation was limited by older adults' reluctance to accept their help; (d) caregivers were largely unavailable, unreliable, or peripheral; or (e) client's unpaid support networks were diffuse without a clearly central or identifiable "caregiver." Findings are used to nuance and problematize widely held assumptions about caregivers, particularly their availability and capacity. Discussion highlights the need for research, policy, and programs related to unpaid caregiving to better reflect the lived realities of this support for older adults and often overlooked sources of diversity in caregiver circumstances and roles. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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12. Immigrant women family caregivers in Canada: implications for policies and programmes in health and social sectors.
- Author
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Stewart, M. J., Neufeld, A., Harrison, M. J., Spitzer, D., Hughes, K., and Makwarimba, E.
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CAREGIVERS ,CARE of people ,HOME care services ,SOCIAL policy - Abstract
Migration has become a profound global phenomenon in this century. In Canada, uncoordinated policies, including those related to immigration, resettlement, employment, and government funding for health and social services, present barriers to immigrant women caregivers. The purpose of this paper is to share relevant insights from individual and group interviews with immigrant women family caregivers, service providers and policy influencers, and discuss these in relation to immigration, health and social policy, and programme trends in Canada. The present authors conducted individual interviews with immigrant women family caregivers ( n = 29) in phase 1, followed by two group interviews with women family caregivers ( n = 7), and two group interviews with service providers and policy-makers ( n = 15) in phase 2. Using an inductive approach, the authors employed thematic content data analysis. Immigrant women experienced barriers to health and social services similar to Canadian-born family caregivers, particularly those who have low incomes, jobs with limited flexibility and heavy caregiving demands. These immigrant women family caregivers avoided certain formal services for a variety of reasons, including lack of cultural sensitivity. However, their challenges were compounded by language, immigration and separation from family in the home country. The identified barriers to support reinforce the importance of modifying and expanding policies and programmes affecting immigrant women's ability to care for family members with illnesses or disabilities within the context of Canadian society. Participants recommended changes to policies and programmes to deal with information, transportation, language, attitudinal and network barriers. The various barriers to services and programmes which were experienced by immigrant women caregivers underscore the importance of reviewing policies affecting immigration, caregiving, and access to health and social services. Intersectoral collaboration among agencies is essential to reduce the barriers identified in the present study, and to establish services which are linguistically and culturally appropriate. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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13. Support for very old people in Sweden and Canada: the pitfalls of cross-cultural studies; same words, different concepts?
- Author
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Miedema, Baukje (Bo) and De Jong, Jennifer
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ELDER care ,OLDER people ,MEDICAL care ,PUBLIC welfare ,CARE of people - Abstract
The Swedish and Canadian 80+ studies are collecting longitudinal data regarding medical, psychological and sociological aspects of the lives of people who are 80 years of age and older. A paper entitled‘Informal and formal support from a multidisciplinary perspective: a Swedish follow-up between 80 and 82 years of age’, was based on the Swedish 80+ study. It examined psychosocial and health measures by support type (i.e. no support, and formal and informal support). Support is defined as care given by either friends and family (informal support) or healthcare professionals (formal support). The present paper compares participant characteristics between two groups of 80-year-olds from two study sites (i.e. Lund, Sweden, and Fredericton, NB, Canada), using the Swedish study site data. Only those participants who participated at both 80 and 82 years of age were included in the analyses. The intent of the descriptive analyses was to compare cross-culturally the two groups of participants and the level of support that they received. Between the two groups, the level of support received by the participants was rather dissimilar: Canadians reported receiving far more informal and formal support compared to Swedes. This finding was despite the fact that the Swedish state provides more funded support than that of Canada to its citizens. Therefore, the present authors speculate that the concept of support has a different meaning in Sweden than in Canada. This speculation raises concerns about cross-cultural studies, particularly when survey questions involve culturally ambiguous concepts such as the term‘support’. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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14. Peer bullying in seniors' subsidised apartment communities in Saskatoon, Canada: participatory research.
- Author
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Goodridge, Donna, Heal‐Salahub, Jennifer, PausJenssen, Elliot, James, George, and Lidington, Joan
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BULLYING ,HEALTH promotion ,HOUSING ,QUALITY of life ,QUESTIONNAIRES ,RESIDENTIAL patterns ,INDEPENDENT living ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Given that 'home' is the major physical-spatial environment of many older adults and that home, social and neighbourhood environments are well-recognised to impact both the ability to age in place and quality of life in this population, a better understanding of the nature of social interactions within seniors' communal living environments is critical for health promotion. This paper describes a two-phase participatory research study examining peer bullying by older adults conducted in April and May, 2016. Responding to needs expressed by tenants, the objectives of this study were to identify the nature, prevalence and consequences of peer bullying for tenants of two low-income senior apartment communities. In collaboration with the local Older Adult Abuse Task Force, a screening survey on bullying was distributed to all tenants. Findings (n = 49) indicated that 39% of tenants had witnessed peer bullying and 29% had experienced bullying by peers. An adapted version of a youth bullying survey was administered in follow-up face-toface interviews with 13 tenants. The most common forms of peer bullying were deliberate social exclusion and hurtful comments. The majority of respondents indicated that bullying was a problem for seniors and that bullies hurt other people. Outcomes of bullying included feelings of dejection and difficulties conducting everyday activities. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
15. Expanding the meaning of 'being a peer leader': qualitative findings from a Canadian community-based cervical and breast cancer screening programme.
- Author
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Ahmad, Farah, Ferrari, Manuela, Moravac, Catherine, Lofters, Aisha, and Dunn, Sheila
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CERVIX uteri tumors ,BREAST tumors ,EARLY detection of cancer ,COMMUNITY health services ,EXPERIENCE ,FOCUS groups ,HEALTH services accessibility ,HEALTH status indicators ,INTELLECT ,PATIENT education ,PEER counseling ,POVERTY ,RESEARCH funding ,SATISFACTION ,HEALTH self-care ,SUPPORT groups ,SELF-perception ,SOCIAL role ,LEADERS ,HEALTH literacy ,PSYCHOLOGY ,CANCER & psychology - Abstract
Engagement of community members to act as peer workers is a key feature of many community-centred health promotion programmes. However, little is known about their experiences beyond the commonly reported themes of fulfilment through helping people in need and improvement of personal confidence, self-esteem and self-care. This gap in the literature is of particular interest given increasing involvement of peer workers in community-centred programmes addressing health disparities, such as uptake of cancer screening. This paper aims to explore experiences of the peer leaders who worked for the Cancer Awareness: Ready for Education and Screening ( CARES) project to promote awareness, knowledge, and uptake of breast and cervical cancer screening among under-/never-screened women who belonged to ethnic minority, recent immigrant and low-income communities in Toronto, Canada. In 2013, three focus groups were conducted with 14 peer leaders to explore their experiences. All were immigrant women between 30 and 50 years of age. All discussions were audio recorded and transcribed verbatim. We used situational maps and analysis to create a visual representation of the data, and to investigate peer leaders experiences. Situational analysis was chosen to bring to light dominant and also silent underlying aspects which define the meaning of being a peer leader. The first level of analysis identified main themes that characterised peer leaders' experience: (i) Helping others (women, friends and family) and themselves by improved self-confidence, self-awareness and self-care and (ii) Redefining professional and social positions through their project activities leading to professional development and networking. The second level of analysis explored the redefining process and identified some peer leaders' negotiations in relation to knowledge (science vs. myth), beliefs (fear vs. assurance) and boundaries (private vs. work). Adding to the literature on the peer workers' experience, the findings are discussed in relation to empowerment of peer workers, training implications and theoretical contributions. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
16. 'That would have been beneficial': LGBTQ education for home-care service providers.
- Author
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Daley, Andrea and MacDonnell, Judith A.
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HOME care services ,FOCUS groups ,HEALTH services accessibility ,INTERDISCIPLINARY education ,INTERVIEWING ,RESEARCH methodology ,RESEARCH funding ,STATISTICAL sampling ,QUALITATIVE research ,JUDGMENT sampling ,LGBTQ+ people ,DATA analysis software ,MEDICAL coding - Abstract
This paper reports qualitative findings from a pilot study that explored the lesbian, gay, bisexual, transgender and queer ( LGBTQ) education needs of home-care service providers working in one large, urban Canadian city. The pilot study builds upon research that has documented barriers to health services for diversely situated LGBTQ people, which function to limit access to good-quality healthcare. LGBTQ activists, organisations and allies have underscored the need for health provider education related to the unique health and service experiences of sexual and gender minority communities. However, the home-care sector is generally overlooked in this important body of research literature. We used purposeful convenience sampling to conduct four focus groups and two individual interviews with a total of 15 professionally diverse home-care service providers. Data collection was carried out from January 2011 to July 2012 and data were analysed using grounded theory methods towards the identification of the overarching theme, 'provider education' and it had two sub-themes: (i) experiences of LGBTQ education; and (ii) recommendations for LGBTQ education. The study findings raise important questions about limited and uneven access to adequate LGBTQ education for home-care service providers, suggest important policy implications for the education and health sectors, and point to the need for anti-oppression principles in the development of education initiatives. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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17. Voices of care for adults with disabilities and/or mental health issues in Western Canada: what do families and agencies need from each other?
- Author
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Mooney, Laura R. and Lashewicz, Bonnie
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PEOPLE with disabilities ,CAREGIVERS ,FOCUS groups ,HOME care services ,INTERPROFESSIONAL relations ,INTERVIEWING ,MEDICAL personnel ,MENTAL illness ,NEEDS assessment ,RESEARCH funding ,SOCIAL support ,THEMATIC analysis ,PATIENTS' families - Abstract
Our purpose in this paper is to report on the frustrations and unmet needs of paid, formal caregivers and unpaid, family caregivers who together provide care to adults with disabilities and/or mental health issues. We conducted eight focus group interviews between November 2010 and June 2011 in two large, urban centres and one smaller centre in Western Canada. Four of our focus groups were with family members including adults with disabilities and/or mental health issues, their parents and their siblings, and four were with representatives from agencies providing support and services to adults with disabilities and/or mental health issues and their families. Data were collected from 23 family members and 24 agency representatives who responded to questions about successes and struggles in meeting, and collaborating to meet, care needs of adults with disabilities and/or mental health issues. Each focus group session was digitally recorded and transcribed; field notes were also taken and we thematically analysed data according to family versus agency perspectives of their successes and barriers in care provision and care collaboration. We found that family members desire greater and more effective support in enriching the lives of adults with disabilities and/or mental health issues and in preparing for age-related changes. Agency representatives are keenly aware of the needs and challenges faced by families, yet grapple with being effective collaborators with families of widely varying priorities and styles of care and collaboration. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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18. Mass print media depictions of cancer and heart disease: community versus individualistic perspectives?
- Author
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Clarke, Juanne and Van Amerom, Gudrun
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HEART diseases ,CANCER research ,MASS media & society ,MULTICULTURALISM ,REPORTING of diseases ,ENVIRONMENTAL health ,MEDICAL care ,PRINTERS (Persons) ,EDUCATION - Abstract
This paper is based on a critical discourse content analysis of 40 stories from the 20 highest circulating English-language mass magazines available in Canada and published in Canada or the USA in 2001. It examines the presence or absence of the social determinants perspective in the portrayal of the two most significant causes of morbidity and mortality in these countries: cancer and heart disease. The media analysis documents an absence of reflection of the social determinants viewpoint on these, the most important causes of disease and death. Thus, magazine stories ignore the role of such considerations as income, education level, ethnicity, visible minority or, Aboriginal status, early life experiences, employment and working conditions, food accessibility and quality, housing, social services, social exclusion, or unemployment and employment security in explaining health. Instead, the magazine articles underscore an individualistic approach to disease that assumes that health care is accessible and available to all, and that these diseases are preventable and treatable through individual lifestyle choices in combination with the measures prescribed through conventional medicine. Although cancer and heart disease are framed by a medical discourse, articles tended to emphasise the independence, freedom and power of the individual within the medical care system. The research documents a continuation of the dominance of conventional medicine buttressed by individualism in media stories. Theoretical and methodological issues are discussed. Some of the practical consequences for policy-makers and professionals are noted. [ABSTRACT FROM AUTHOR]
- Published
- 2008
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19. Offloading social care responsibilities: recent experiences of local voluntary organisations in a remote urban centre in British Columbia, Canada.
- Author
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Hanlon, Neil, Rosenberg, Mark, and Clasby, Rachael
- Subjects
SOCIAL services ,VOLUNTARY health agencies ,PUBLIC welfare - Abstract
Services offered by voluntary organisations are an integral but often overlooked component of health and social care. Of late, there has been a renewed interest in voluntary welfare provision as a viable alternative to state and market. Recent developments in welfare provision in Canada appear to have brought greater social care roles for the voluntary sector at the same time as new and arguably more restrictive funding and accountability mechanisms are being imposed by different arms of the state. To explore these issues more closely, the present paper examines the impressions and experiences of voluntary and formal sector providers of services for senior citizens and people with disabilities in a remote urban centre (population less than 100 000) in the interior of British Columbia, Canada. Two important operational pressures provide the context of the analysis: (1) reform of provincial government funding and regulation of voluntary services; and (2) the restructuring of welfare provision, especially in the areas of health care and social services. The authors found evidence of an escalating incursion of the state into local voluntary sector affairs that needs to be understood in the context of long-standing institutional links between government and ‘professional’ voluntary welfare provision in British Columbia. The results point to three important directions in contemporary local voluntary provision: (1) an emerging ethos of accountability, efficiency and competition in voluntary provision; (2) increasing pressure to centralise volunteer services; and consequently, (3) the potential erosion of flexibility and personalisation that are seen to characterise the voluntary sector. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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- View/download PDF
20. Lay understandings of the effects of poverty: a Canadian perspective.
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Reutter, Linda I., Veenstra, Gerry, Stewart, Miriam J., Raphael, Dennis, Love, Rhonda, Makwarimba, Edward, and McMurray, Susan
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POVERTY ,PUBLIC health ,QUALITY of life ,NEIGHBORHOODS - Abstract
Although there is a large body of research dedicated to exploring public attributions for poverty, considerably less attention has been directed to public understandings about the effects of poverty. In this paper, we describe lay understandings of the effects of poverty and the factors that potentially influence these perceptions, using data from a telephone survey conducted in 2002 on a random sample ( n = 1671) of adults from eight neighbourhoods in two large Canadian cities (Edmonton and Toronto). These data were supplemented with interview data obtained from 153 people living in these same neighbourhoods. Multivariate linear and logistic regressions were used to determine the effects of basic demographic variables, exposure to poverty and attribution for poverty on three dependent variables relating to the effects of poverty: participation in community life, the relationship between poverty and health and challenges facing low-income people. Ninety-one per cent of survey respondents agreed that poverty is linked to health, while 68% agreed that low-income people are less likely to participate in community life. Affordable housing was deemed especially difficult to obtain by 96%, but other resources (obtaining healthy food, giving children a good start in life, and engaging in healthy behaviours) were also viewed as challenging by at least 70% of respondents. The regression models revealed that when controlling for demographics, exposure to poverty explained some of the variance in recognising the effects of poverty. Media exposure positively influenced recognition of the poverty–health link, and attending formal talks was strongly related to understanding challenges of poverty. Attributions for poverty accounted for slightly more of the variance in the dependent variables. Specifically, structural and sociocultural attributions predicted greater recognition of the effects of poverty, in particular the challenges of poverty, while individualistic attributions predicted less recognition. Older and female respondents were more likely to acknowledge the effects of poverty. Income was positively associated with recognition of the poverty–health link, negatively associated with understanding the challenges of low-income people, and unrelated to perceptions of the negative effect of poverty on participation in community life. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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- View/download PDF
21. Queering Public Health: A Critical Examination of Healthcare Access and Gender Expression among Trans, Nonbinary, and Other Gender Nonconforming People during COVID-19.
- Author
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Grey, Cornel, Sinno, Jad, Zhang, Haochuan, Daroya, Emerich, Skakoon-Sparling, Shayna, Klassen, Ben, Lessard, David, Hart, Trevor A., Cox, Joseph, Stewart, Mackenzie, and Grace, Daniel
- Subjects
HEALTH services accessibility ,GROUNDED theory ,PUBLIC health ,NONBINARY people ,GENDER-nonconforming people ,INTERVIEWING ,CONCEPTUAL structures ,GENDER identity ,SOUND recordings ,DATA analysis software ,COVID-19 pandemic ,GENDER expression ,LONGITUDINAL method - Abstract
Research documenting the impact of COVID-19 on Two-Spirit, lesbian, gay, bisexual, transgender, and queer (2SLGBTQ+) populations in Canada is limited. Our objectives were to investigate the impact of COVID-19 lockdown measures on the lives of trans, nonbinary, and other gender nonconforming (TGNC) people. Engage COVID-19 is a mixed methods study examining the impact of COVID-19 on gay, bisexual, queer, and other men who have sex with men (GBQM) living in Vancouver, Toronto, and Montreal, Canada. Using purposive sampling, we conducted in-depth qualitative interviews (between November 2020–February 2021 and June–October 2021) with 93 participants who discussed the impact of COVID-19 on their lives. Seventeen participants were identified as TGNC. TGNC participants reported barriers to trans healthcare during the initial months of the COVID-19 pandemic. Several participants indicated that some public health interventions during COVID-19 (i.e., lockdowns) eased the pressure to "perform" gender due to fewer in-person interactions. During lockdowns, TGNC participants increasingly cultivated community networks online. Nevertheless, participants reported longing for the social support that was available to them during pre-COVID. Lack of access to community spaces during lockdowns had a negative impact on participants' mental health, despite reduced pressure to perform gender and opportunities for social engagement in online spaces. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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- View/download PDF
22. Towards the Quadruple Aim in permanent supportive housing: A mixed methods study of workplace mental health among service providers.
- Author
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Kerman, Nick, Goodwin, Jordan M., Tiderington, Emmy, Ecker, John, Stergiopoulos, Vicky, and Kidd, Sean A.
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HEALTH policy ,WORK environment ,WELL-being ,STATISTICS ,SOCIAL support ,WORK ,SOCIAL workers ,RESEARCH methodology ,INDEPENDENT variables ,MULTIVARIATE analysis ,MENTAL health ,INTERVIEWING ,QUANTITATIVE research ,PUBLIC housing ,QUALITATIVE research ,CRONBACH'S alpha ,EXPERIENTIAL learning ,SECONDARY traumatic stress ,RESEARCH funding ,HOMELESSNESS ,LOGISTIC regression analysis ,THEMATIC analysis ,DATA analysis software ,PSYCHOLOGICAL distress - Abstract
The Quadruple Aim is a health policy framework with the objective of concurrently improving population health, enhancing the service experience, reducing costs and improving the work‐life of service providers. Permanent supportive housing (PSH) is a best practice approach for stably housing people experiencing homelessness who have diverse support needs. Despite the intervention's strong evidence base, little is known about the work‐life of PSH providers. This study explored the mental health and work challenges experienced by PSH providers in Canada. Using an explanatory sequential, equally weighted, mixed methods design, 130 PSH providers were surveyed, followed by semi‐structured interviews with 18 providers. Quantitative findings showed that 23.1% of PSH providers had high psychological distress. Participants who were younger, spent all or almost all of their time in direct contact with service users and had less social support from coworkers were significantly more likely to have high psychological distress. Three themes were identified from the qualitative analysis that showed how PSH providers experience psychological distress from work‐related challenges: (a) Sisyphean Endeavours: 'You Do What You Can', (b) Occupationally Unsupported: 'Everyone Is Stuck in Their Zone' and (c) Wear and Tear of 'Continuous Exposure to Crisis and Chaos'. The themes interacted with systemic (Sisyphean Endeavours) and organisational issues (Occupationally Unsupported), intensifying the emotional burden of day‐to‐day work, which involved frequent crises and uncertainty (Wear and Tear of 'Continuous Exposure to Crisis and Chaos'). The findings underscore how these challenges threaten providers' wellness at work and have implications for the care provided to service users. Accordingly, the Quadruple Aim is a potentially useful and applicable framework for measuring the performance of PSH programs, which warrants further consideration in research and policy. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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23. Gains and losses within the homeless service, supportive housing, and harm reduction sectors during the COVID‐19 pandemic: A qualitative study of what matters to the workforce.
- Author
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Goodwin, Jordan M., Tiderington, Emmy, Kidd, Sean A., Ecker, John, and Kerman, Nick
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PROFESSIONAL ethics ,OCCUPATIONAL roles ,WORK ,ATTITUDES of medical personnel ,COMMUNITY health services ,MENTAL health ,WORK-life balance ,HARM reduction ,EXPERIENCE ,ORGANIZATIONAL change ,QUALITATIVE research ,SOCIAL boundaries ,COMMUNITY-based social services ,EXPERIENTIAL learning ,INTERPERSONAL relations ,DESCRIPTIVE statistics ,INTERPROFESSIONAL relations ,RESEARCH funding ,JUDGMENT sampling ,THEMATIC analysis ,INDUSTRIAL hygiene ,DATA analysis software ,HOMELESSNESS ,COVID-19 pandemic - Abstract
The COVID‐19 pandemic has had deleterious effects on individuals experiencing homelessness; yet, less is known about how this global health crisis is impacting service providers that support the homeless population. This qualitative study examined the perceived impacts of the COVID‐19 pandemic on the lives and work experiences of service providers in the homeless service, supportive housing, and harm reduction sectors in Canada. Further analyses were conducted to identify the occupational values that were represented in the work‐related changes experienced by providers. A stratified purposive sample of 40 participants (30 direct service providers and 10 providers in leadership roles) were drawn from a pan‐Canadian study of the mental health of service providers working with individuals experiencing homelessness. Reflexive thematic analysis was used to identify five themes of the work‐related changes experienced by service providers during the pandemic: [1] "Everything was changing every day": Work role and responsibility instability; [2] "How on Earth do we do our job?": Challenges to working relationships with service users; [3] "It used to be a social environment": Transitions to impersonal and isolating workspaces; [4] "It all comes down the chute": Lack of organisational support and hierarchical conflict; and [5] "We've been supported as well as we could have": Positive organisational support and communication. The findings underscored how many of the occupational changes during the pandemic did not align with service providers' occupational values for collaboration, control, effective and safe service provision, and the importance of human relationships, among other values. As pre‐existing sectoral problems were exacerbated by the pandemic, recovery efforts need to address these long‐standing issues in ways that are aligned with service providers' values. Future research is warranted on how organisational approaches can promote supportive workplaces for service providers and improve outcomes for individuals experiencing homelessness. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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- View/download PDF
24. Mental health needs of homeless and recently housed individuals in Canada: A meta‐ethnography.
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Diduck, Bronte, Rawleigh, Mikaela, Pilapil, Alexandra, Geeraert, Erin, Mah, Amanda, and Chen, Shu‐Ping
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WELL-being ,FOCUS groups ,SOCIAL determinants of health ,TRANS women ,MENTAL health ,INTERVIEWING ,QUALITATIVE research ,TRANS men ,THEMATIC analysis - Abstract
Homeless individuals are disproportionately likely to experience mental health conditions, and typically face many systemic barriers to access mental health services. This study sought to determine the mental health needs of homeless and recently housed individuals in Canada. A meta‐ethnography was conducted to synthesise existing qualitative data and translate themes across a broader context. Thirty‐five studies on the experiences of 1511 individuals with a history of homelessness were included. Themes were interpreted by comparing and contrasting findings across multiple contexts. Distinct, yet highly interrelated, unmet mental health needs were revealed through personal narratives of trauma, stigmatisation, victimisation, and a lack of basic necessities. Six themes that characterised this population's mental health needs were ontological security, autonomy, hope and purpose, empowerment, social connection and belonging, and access to services. This study revealed homeless individuals' unmet mental health needs to inform social and policy change and improve psychological well‐being. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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- View/download PDF
25. The development of community paramedicine; a restricted review.
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Shannon, Brendan, Eaton, Georgette, Lanos, Chelsea, Leyenaar, Matthew, Nolan, Mike, Bowles, Kelly‐Ann, Williams, Brett, O'Meara, Peter, Wingrove, Gary, Heffern, JD, and Batt, Alan
- Subjects
CLINICAL governance ,EVALUATION of human services programs ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,COMMUNITY health services ,MEDICAL care ,PATIENT satisfaction ,COMMUNITY-based social services ,DESCRIPTIVE statistics ,RESEARCH funding ,SUPERVISION of employees ,MEDLINE ,DATA analysis software ,EDUCATIONAL attainment ,ERIC (Information retrieval system) - Abstract
Community paramedic roles are expanding internationally, and no review of the literature could be found to guide services in the formation of community paramedicine programmes. For this reason, the aim of this restricted review was to explore and better understand the successes and learnings of community paramedic programmes across five domains being; education requirements, models of delivery, clinical governance and supervision, scope of roles and outcomes. This restricted review was conducted by searching four databases (CENTRAL, ERIC, EMBASE, MEDLINE and Google Scholar) as well as grey literature search from 2001 until 28/12/2021. After screening, 98 articles were included in the narrative synthesis. Most studies were from the USA (n = 37), followed by Canada (n = 29). Most studies reported on outcomes of community paramedicine programmes (n = 50), followed by models of delivery (n = 28). The findings of this review demonstrate a lack of research and understanding in the areas of education and scope of the role for community paramedics. The findings highlight a need to develop common approaches to education and scope of role while maintaining flexibility in addressing community needs. There was an observable lack of standardisation in the implementation of governance and supervision models, which may prevent community paramedicine from realising its full potential. The outcome measures reported show that there is evidence to support the implementation of community paramedicine into healthcare system design. Community paramedicine programmes result in a net reduction in acute healthcare utilisation, appear to be economically viable and result in positive patient outcomes with high patient satisfaction with care. There is a developing pool of evidence to many aspects of community paramedicine programmes. However, at this time, gaps in the literature prevent a definitive recommendation on the impact of community paramedicine programmes on healthcare system functionality. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
26. Improving services for parents with intellectual disability and their families: Views of Canadian social service workers.
- Author
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Pacheco, Laura, Aunos, Marjorie, Feldman, Maurice, and McConnell, David
- Subjects
SOCIAL support ,RESEARCH methodology ,FAMILIES ,QUALITATIVE research ,PARENTING ,SOCIAL worker attitudes ,QUALITY assurance ,DESCRIPTIVE statistics ,PEOPLE with intellectual disabilities ,SOCIAL services ,PARENT-child relationships ,DATA analysis software - Abstract
How adults with intellectual disability fare in the parenting role depend, to varying degrees, on the adequacy of supports and services provided. The available research suggests that service providers are often ill‐equipped to accommodate their support needs. The purpose of this qualitative descriptive study was to explore the perspectives of Canadian social service workers on what is required to improve services and build systems capacity to more effectively support parents with intellectual disability, their children and families. A total of 39 workers, identified by parents with intellectual disability as their key workers, were interviewed. To build systems capacity to support these parents and families, and to address institutionalised discrimination, key workers highlighted the need for entry‐to‐practice and continuing professional education to develop worker capabilities for reflective practice, relationship‐building and research utilisation; accommodative caseload management, giving workers the time, flexibility and the professional supervision they need to deal with complexity and fashion individualised service responses; and, a common framework, with defined service pathways, to facilitate interagency case planning and, in turn, continuity in service provision. The question is not whether adults with intellectual disability can be effectively supported in the parenting role; the question is whether the political will exists to do what is necessary to ensure they are. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
27. Intimate partner violence against women with intellectual disability: A relational framework for inclusive, trauma‐informed social services.
- Author
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McConnell, David and Phelan, Shanon K.
- Subjects
INTIMATE partner violence ,SAFETY ,SOCIAL support ,SOCIAL workers ,WOMEN ,CONCEPTUAL structures ,ABILITY ,TRAINING ,RESEARCH funding ,AUTONOMY (Psychology) ,SOCIAL status ,INTERPERSONAL relations ,INTELLECT ,PEOPLE with intellectual disabilities - Abstract
Women with intellectual disability experience intimate partner violence at higher rates and tend to remain in abusive relationships longer than non‐disabled women. The purpose of this inquiry was to generate a preliminary set of principles and delineate domains of support as a general guide for social service workers supporting women with intellectual disability through the difficult, often stop‐start process of ending an abusive relationship and creating a desired future. Taking a pragmatic inquiry approach, guiding principles and domains of support were generated through a triangulated engagement with relational theory, relevant published research, and original data gathered through interviews with five experienced social service workers. The results comprise a relational framework for inclusive, trauma‐informed services aimed at fostering the relational autonomy of women with intellectual disability. Enacting relational principles of reflexivity, recognition, solidarity and safety, social service workers can support women with intellectual disability with safety planning, securing basic life needs, strengthening social relationships, acquiring new skills and nurturing self‐affective attitudes of self‐respect, self‐efficacy and self‐esteem. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
28. The impact of the Caremongering social media movement: A convergent parallel mixed‐methods study.
- Author
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Bishop, Valerie, Bainbridge, Daryl, Kumar, Shilpa, Williams, Allison, Law, Madelyn, Pesut, Barbara, Chochinov, Harvey, and Seow, Hsien
- Subjects
COMMUNITY services ,CHARITY ,MEDICINE information services ,FOOD relief ,SOCIAL media ,RESEARCH methodology ,CROSS-sectional method ,COMMUNITY support ,PUBLIC health ,INTERVIEWING ,SURVEYS ,HEALTH information services ,RESEARCH funding ,JUDGMENT sampling ,THEMATIC analysis ,DATA analysis software ,COVID-19 pandemic ,HEALTH promotion - Abstract
Public health responses to the COVID‐19 pandemic, such as business restrictions, social distancing and lockdowns, had social and economic impacts on individuals and communities. Caremongering Facebook groups spread across Canada to support vulnerable individuals by providing a forum for sharing information and offering assistance. We sought to understand the specific impacts of Caremongering groups on individuals 1 year after the pandemic began. We used a convergent parallel mixed‐methods approach that included semi‐structured interviews with group moderators from 16 Caremongering groups and survey data from 165 group members. We used a constant comparative approach for thematic analysis of interview transcripts and open‐ended text responses to the survey. We used source theme tables as joint displays to integrate interview and survey findings. Our results revealed five major themes: providing food, sharing information, supporting health and wellness, acquiring goods and services (non‐food), and connecting communities. Respondents of our survey tended to be 35–65 years of age range, but reported helping adults of all ages. Our findings illustrate the potential of using a social media platform to connect with others and provide and access support. The Caremongering initiative demonstrates a community‐driven, social media solution to issues such as isolation, loneliness and community health promotion. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
29. Perceptions of caregiving for people living with dementia and help‐seeking patterns among prospective Korean caregivers in Canada.
- Author
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Lee, Eunyoung
- Subjects
CAREGIVER attitudes ,IMMIGRANTS ,RESEARCH ,RESEARCH methodology ,ATTITUDES of medical personnel ,HELP-seeking behavior ,INTERVIEWING ,QUALITATIVE research ,DEMENTIA patients ,CONCEPTUAL structures ,DEMENTIA ,HEALTH attitudes ,CULTURAL competence ,RESEARCH funding ,JUDGMENT sampling ,STATISTICAL sampling ,SOCIAL services ,THEMATIC analysis - Abstract
Due to cultural influences, people from some ethnic minority groups expect to provide caregiving for their family members who suffer from illness. Little is known about the expectations about caregiving and the help‐seeking process among the Korean population in Canada. Thus, the purpose of this study is to examine perceptions of caregiving for people living with dementia and help‐seeking patterns among prospective Korean caregivers who anticipate becoming primary caregivers of their older relatives with dementia. An exploratory qualitative study was conducted in Montreal, Canada. In‐depth semi‐structured interviews were conducted with nine prospective Korean caregivers. The interviews were analysed using a qualitative thematic analysis. This study found four emerging themes: (1) the importance of family care; (2) the ability to find resources outside of the family; (3) the roles of Korean churches as a support system and; (4) the perceptions of service providers and health care settings. The findings of this study suggest that linguistic support services enable family caregivers to access more health and social services. Resources may be more easily accessed by Korean communities when provided through churches. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
30. Effectiveness of employment‐based interventions for persons experiencing homelessness: A systematic review.
- Author
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Marshall, Carrie Anne, Boland, Leonie, Westover, Lee Ann, Goldszmidt, Rebecca, Bengall, Jordana, Aryobi, Suliman, Isard, Roxanne, Easton, Corinna, and Gewurtz, Rebecca
- Subjects
WELL-being ,PSYCHOLOGY information storage & retrieval systems ,CINAHL database ,SUBSTANCE abuse ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,EMPLOYEE promotions ,RACE ,EMPLOYMENT ,RESEARCH funding ,DESCRIPTIVE statistics ,HOMELESSNESS ,PUBLIC welfare ,VOCATIONAL rehabilitation ,HOUSING ,MEDLINE ,SUPPORTED employment - Abstract
Employment is frequently desired by persons who experience homelessness yet is often elusive. Little is known about the range and effectiveness of employment‐based interventions evaluated in existing literature on key psychosocial outcomes including employment participation, mental well‐being, housing tenure, community integration and substance use. To identify and synthesise existing studies, we conducted a systematic review of effectiveness using the methodology proposed by the Joanna Briggs Institute (JBI) following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Following the removal of duplicates, we screened 13,398 titles and abstracts, and reviewed 79 studies at the full‐text review stage using two independent raters. A total of 16 studies met criteria for inclusion in a narrative synthesis and were subjected to critical appraisal. The majority of studies were conducted in the US (n = 14; 87.5%) with other studies published in Canada (n = 1; 6.3%) and Australia (n = 1; 6.3%). Interventions evaluated in existing studies included combined substance use and vocational skills interventions (n = 7; 43.8%), supported employment (n = 6; 37.5%), and integrated supports including an employment component (n = 3; 18.8%). The effectiveness of these interventions on employment, mental well‐being, housing tenure, community integration, and substance use is presented. Findings suggest that research evaluating employment interventions for persons who experience homelessness is in an early stage of development. Researchers and practitioners may consider collaborating with persons with lived experiences of homelessness and practitioners in co‐designing and modifying existing approaches to target key outcomes more effectively. Policymakers may consider allocating resources to such initiatives to further the development of practice and research aimed at supporting persons who experience homelessness to secure and sustain employment during and following homelessness. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
31. "A right place for everybody": Supporting aging in the right place for older people experiencing homelessness.
- Author
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Weldrick, Rachel, Canham, Sarah L., Sussman, Tamara, Walsh, Christine A., Mahmood, Atiya, Nixon, Lara, and Burns, Victoria F.
- Subjects
CONGREGATE housing ,AGING ,PSYCHOSOCIAL factors ,RESEARCH funding ,DESCRIPTIVE statistics ,HOMELESS persons ,HOMELESSNESS ,THEMATIC analysis ,DATA analysis software ,OLD age - Abstract
While policies and practices that promote aging in place have risen in prominence over the last two decades, marginalised older adults have largely been overlooked. 'Aging in the right place' is a concept that recognises the importance of adequate and appropriate age‐related health and psychosocial supports in shelter/housing settings and their impact on the ability of older people to age optimally. To understand the unique shelter/housing challenges and solutions that affect aging in the right place for older people experiencing homelessness (OPEH), we conducted three World Café workshops in three Canadian cities—Montreal, Calgary, and Vancouver. In total, 89 service providers and OPEH engaged in the workshops, which involved guided, small‐table discussions with the goal of stimulating creative ideas and fostering a productive atmosphere. Findings revealed two overarching themes 1) Discrepancies, between the need and availability of housing options and community supports for OPEH, such as affordable transportation, case management, access to healthcare, and system navigation; and 2) Desires, for more peer support, participatory planning, service‐enriched housing, social programming, and policies that promote agency, independence, and choice for OPEH. These findings provide evidence to inform the development or modification of housing and supports for OPEH that promote aging in the right place. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
32. Differential impacts of COVID‐19 and associated responses on the health, social well‐being and food security of users of supportive social and health programs during the COVID‐19 pandemic: A qualitative study.
- Author
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Mejia‐Lancheros, Cilia, Alfayumi‐Zeadna, Samira, Lachaud, James, O'Campo, Patricia, Gogosis, Evie, Da Silva, George, Stergiopoulos, Vicky, Hwang, Stephen W., and Thulien, Naomi
- Subjects
HEALTH services accessibility ,COVID-19 ,SOCIAL support ,FOOD security ,RESEARCH methodology ,PUBLIC health ,COMMUNITY health services ,INTERVIEWING ,POST-traumatic stress disorder ,SANITATION ,PATIENTS' attitudes ,EXPERIENCE ,QUALITATIVE research ,SOCIAL isolation ,HEALTH ,COMMUNITY-based social services ,DESCRIPTIVE statistics ,MENTAL depression ,LONELINESS ,QUALITY of life ,SOUND recordings ,RESEARCH funding ,HEALTH impact assessment ,HOMELESSNESS ,THEMATIC analysis ,ANXIETY ,HEALTH equity ,PERSONAL protective equipment ,COVID-19 pandemic ,MENTAL illness ,PSYCHOLOGICAL stress ,PARANOIA ,OBSESSIVE-compulsive disorder - Abstract
The effects of the coronavirus disease‐2019 (COVID‐19) pandemic on the lives of underserved populations are underexplored. This study aimed to identify the impacts of the COVID‐19 pandemic and associated public health responses on the health and social well‐being, and food security of users of Housing First (HF) services in Toronto (Canada) during the first wave of the COVID‐19 pandemic. This qualitative descriptive study was conducted from July to October 2020 in a subsample of 20 adults with a history of homelessness and serious mental disorders who were receiving HF services in Toronto. A semi‐structured interview guide was used to collect narrative data regarding health and social well‐being, food security and access to health, social and preventive services. A thematic analysis framework guided analyses and interpretation of the data. The COVID‐19 pandemic and response measures had a variable impact on the health, social well‐being and food security of participants. Around 40% of participants were minimally impacted by the COVID‐19 pandemic. Conversely, among the remaining participants (impacted group), some experienced onset of new mental health problems (anxiety, stress, paranoia) or exacerbation of pre‐existing mental disorders (depression, post‐traumatic stress disorder and obsessive‐compulsive disorder). They also struggled with isolation and loneliness and had limited leisure activities and access to food goods. The pandemic also contributed to disparities in accessing and receiving healthcare services and treatment continuity for non‐COVID‐19 health issues for the negatively impacted participants. Overall, most participants were able to adhere to COVID‐19 public health measures and get reliable information on COVID‐19 preventive measures facilitated by having access to the phone, internet and media devices and services. In conclusion, the COVID‐19 pandemic and associated response measures impacted the health, social well‐being, leisure and food security of people with experiences of homelessness and mental disorders who use supportive social and housing services in diverse ways. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
33. How central support built capacity to deliver a health‐promoting intervention for older adults in Canada.
- Author
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Sims‐Gould, Joanie, McKay, Heather A., and Franke, Thea
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FOCUS groups ,RESEARCH methodology ,INTERVIEWING ,PHYSICAL activity ,HUMAN services programs ,RESEARCH funding ,HEALTH promotion - Abstract
Most implementation frameworks note that a central support unit (CSU) is key to successful implementation and scale‐up of evidence‐based interventions (EBIs). However, few studies investigated core functions of CSUs—such as capacity building—to better understand their essential role in implementing EBIs at scale. Therefore, the aims of our study are to (1) describe the role that a CSU plays to build capacity in delivery partner organisations, to enable implementation and scale‐up of a health‐promoting intervention (Choose to Move [CTM]) for older adults, and (2) identify elements within capacity‐building strategies deemed essential to effectively implement CTM in diverse community contexts. CTM is a flexible, scalable, community‐based health‐promoting physical activity (PA) and social connectedness intervention for older adults. In 2018–2020, eight health and social service societies, rural or remote municipalities or community‐based organisations delivered 22 CTM programmes that served 322 older adults. We conducted in‐depth interviews with delivery partners (n = 23), and a focus group with the central support system (n = 4). CSU provided a sounding board to organisations to create buy‐in (adoption) and plan ahead. Essential elements within capacity‐building strategies included: a support unit champion, enhanced delivery partner skills, self‐efficacy and confidence; interactive assistance to answer questions and clarify materials. There is a key role for capacity‐building under the stewardship of the CSU to promote implementation success. Investigating specific elements within capacity‐building strategies that drive implementation success continues to be a relevant question for implementation science researchers, that deserves further attention. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
34. Quality home care for persons living with dementia: Personal support workers' perspectives in Ontario, Canada.
- Author
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Breen, Rachel, Savundranayagam, Marie Y., Orange, Joseph B., and Kothari, Anita
- Subjects
TREATMENT of dementia ,CAREGIVER attitudes ,MEDICAL quality control ,TEAMS in the workplace ,CAREGIVERS ,HOME care services ,ATTITUDES of medical personnel ,RESEARCH methodology ,UNLICENSED medical personnel ,INTERVIEWING ,PATIENT-centered care ,DEMENTIA patients ,QUALITATIVE research ,LABOR supply ,DEMENTIA ,ACCESS to information ,DESCRIPTIVE statistics ,CONTENT analysis ,PATIENT education - Abstract
There is a global need to understand how the quality of home care for persons living with dementia is perceived by their most frequent formal caregivers, personal support workers (PSW), especially given the expected rise in the prevalence of dementia. The aim of this study was to explore the perceptions of PSW regarding what constitutes quality home care for persons with dementia. Qualitative content analysis was undertaken to interpret semi‐structured interviews with PSW (N = 15). Study findings indicate that quality home care is perceived to be (1) person‐centered; (2) provided by PSW with dementia‐specific education and training; (3) facilitated by specific PSW experiences, abilities and characteristics; (4) enhanced by accessible information, services and education for persons with dementia and their caregivers; (5) provided by an inclusive dementia care team; and (6) facilitated by organisational supports and respect. However, findings also indicated differences in what PSW perceive as quality home care versus what they are experiencing when providing care for persons with dementia. Participants advocated for increased supports to them through ongoing dementia‐specific education and training, increased teamwork among care providers, increased wages, sufficient and qualified staffing, and increased exchange of client information. The findings highlight the importance of exploring front‐line workers' perspectives and how they can help revise current healthcare policies and inform future policy development. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
35. Wraparound programmes for pregnant and parenting women with substance use concerns in Canada: Partnerships are essential.
- Author
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Hubberstey, Carol, Rutman, Deborah, Van Bibber, Marilyn, and Poole, Nancy
- Subjects
MATERNAL health services ,CULTURAL identity ,SUBSTANCE abuse ,SOCIAL determinants of health ,RESEARCH methodology ,PREGNANT women ,INTERVIEWING ,TRANSCULTURAL medical care ,PARENTING ,INTERPROFESSIONAL relations ,QUESTIONNAIRES ,RESEARCH funding ,DATA analysis software ,THEMATIC analysis - Abstract
Wraparound programmes, wherein multiple services are offered at one location, are effective in engaging pregnant or parenting women experiencing substance use and other complex challenges while also addressing gaps in services between the health, child welfare and addictions fields. Evaluations of these programmes have demonstrated positive outcomes; nevertheless, few studies have focused on how programmes' cross‐sectoral partnerships are structured and the difference these partnerships make. Drawing on the Co‐Creating Evidence study, a three‐year Canadian evaluation of eight multi‐service programmes in six provinces, this article examines the partnerships that make wraparound service delivery possible. The study used a mixed‐methods design involving interviews, questionnaires, output and de‐identified client data; this article reports on qualitative findings only. Sixty service partners and 108 programme staff were interviewed in 2018 and 2019. Qualitative data analysis techniques were applied; NVivo12 software (QRS International, Melbourne, Australia) was utilised to facilitate the analyses. In terms of the programmes' partnership characteristics, overall, programmes more commonly formed partnerships with child welfare, health services (e.g. primary care, public health and perinatal care) and specialised health services such as mental health services, maternal addictions and Opioid Agonist Therapy. The programmes had fewer partnerships with housing, income assistance, Indigenous cultural programming, infant development and legal services. Key benefits of partnerships included: clients' improved access to health and social care, addressing social determinants of health; partners' increased knowledge about the significance of trauma in relation to women's substance use; improved child welfare outcomes and strengthened cultural safety and (re)connection. Key challenges included: tensions between partners regarding differing perceptions, mandates and responsibilities; personal differences and systemic barriers. Lastly, by means of steady dialogue and collaboration, partners increased their appreciation and use of the trauma‐informed, harm reduction approaches that are central to wraparound programmes. [ABSTRACT FROM AUTHOR]
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- 2022
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36. Exploring the delivery of community rehabilitation services for older people in an urban Canadian setting: Perspectives of service providers, managers and health system administrators.
- Author
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Leclair, Leanne L., Zawaly, Kathleen, Korall, Alexandra M. B., Edwards, Jeanette, Katz, Alan, and Sibley, Kathryn M.
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HEALTH policy ,HEALTH services accessibility ,ATTITUDES of medical personnel ,FUNCTIONAL status ,COMMUNITY health services ,MEDICAL care ,EXECUTIVES ,INTERVIEWING ,QUALITATIVE research ,WORKFLOW ,SOCIOECONOMIC factors ,CONTINUUM of care ,RESEARCH funding ,AGING ,REHABILITATION ,GERIATRIC rehabilitation ,THEMATIC analysis - Abstract
As the global population of older people increases, policies aimed at improving health care delivery for older people often include supports for ageing in place. Living in the community not only reduces institutionalisation but also improves quality of life and reduces health care costs. For older people, community rehabilitation offers the opportunity to preserve and maximise function while maintaining the ability to live in the community. However, limited research examines the delivery, coordination and integration of community rehabilitation services in health systems. Our case study explored the perspectives of service providers, managers and health system administrators on the strengths, limitations and gaps in community rehabilitation for older people in one Canadian urban health region. Using interpretive description and thematic analysis, we analysed interview data from: 16 service providers, eight managers and five health system administrators. Three themes were identified: (a) Limited Access to Programs and Services; (b) Need to Emphasise Promoting, Maintaining and Restoring Function; and (c) Lack of Flow Across the System. Participants highlighted that restrictive eligibility criteria limited access to services. Services were organised around health conditions that did not address the needs of older people. Long waitlists meant that services were delayed. Transportation costs limited participation of individuals from lower socioeconomic status (SES). Age restrictions did not reflect differences in the ageing process and the health inequities individuals from lower SES groups experienced. There was a lack of emphasis in community rehabilitation programs on maintaining or restoring function in older people, which is the primary focus of rehabilitation. Furthermore, key stakeholders stressed the need for strengthening the integration of service delivery across the continuum of care. The findings underscore the need to develop a conceptual framework for community rehabilitation to promote greater system integration, access and availability of services and to optimise functional outcomes for older people. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
- View/download PDF
37. From laboratory to community: Three examples of moving evidence‐based physical activity into practice in Canada.
- Author
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Wurz, Amanda, Bean, Corliss, Shaikh, Majidullah, Culos‐Reed, S. Nicole, and Jung, Mary E.
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THEORY-practice relationship ,PHYSICAL activity ,CANCER patients ,COMMUNITY-based social services ,INTELLECT ,EXERCISE ,HEALTH promotion ,PREDIABETIC state - Abstract
Physical activity (PA) is important for enhancing and sustaining people's health and well‐being. Although a number of efficacious PA interventions have been developed, few have been translated from research into practice. Consequently, the knowledge‐to‐practice gap continues to grow, leaving many individuals unable to access evidence‐based PA opportunities. This gap may be particularly relevant for those who grapple with poor health due to intrapersonal, interpersonal, cultural and system‐level barriers that limit their access to evidence‐based PA opportunities. Implementation efforts designed to bring research into real‐world settings may bridge the knowledge‐to‐practice gap. Yet, cultivating quality partnerships and ensuring effectiveness, methodological rigour and scalability in real‐world settings can be difficult. Furthermore, researchers seldom publish examples of how they addressed these challenges and translated their evidence‐based PA opportunities into practice. Herein, we describe three cases of successful PA implementation among diverse populations: (a) individuals affected by cancer, (b) adults living with prediabetes, and (c) children from under‐resourced communities. Commonalities across cases include guiding theories and frameworks, the strategies to facilitate and maintain partnerships, and scalability and sustainability plans. Practical tips and recommendations are provided to spur research and translation efforts that consider implementation from the outset, ultimately ensuring that people receive the benefits PA can confer. [ABSTRACT FROM AUTHOR]
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- 2022
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- View/download PDF
38. Competing perspectives on rural homelessness: Findings from a qualitative study in Ontario, Canada.
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RESEARCH ,RURAL conditions ,RESEARCH methodology ,SOCIAL stigma ,INTERVIEWING ,QUALITATIVE research ,RESEARCH funding ,SOUND recordings ,HOMELESSNESS ,DATA analysis software ,THEMATIC analysis ,DRUG abusers - Abstract
Rural homelessness in Canada has only recently been acknowledged, and several gaps remain in our understanding of the phenomenon and how it is influenced by the rural context. This qualitative exploratory study aimed to help understand the experience of housing insecurity, factors that lead to rural homelessness, and potential solutions to the housing crisis in a rural Ontario community. Interviews were conducted with 27 participants: 16 individuals who were housing insecure and 11 key informants who had knowledge of the local homelessness situation. Data collection took place between August 2020 and May 2021 and inductive analysis was concurrent. Findings revealed competing perspectives on the magnitude of the crisis, its root causes, and potential solutions to rural homelessness. The invisible nature of rural homelessness and values of individualism that assign responsibility for homelessness to poor choices rather than structural factors may account for these different perspectives. Stigma also played an important role in how homelessness was understood, particularly for individuals who were homeless and perceived to be using substances. The lack of privacy, limited services, and low housing stock in the rural environment contributed to challenges with overcoming homelessness. Strategies to help improve supports for individuals facing homelessness include anti‐stigma education, capacity building, and inclusion of people with lived experience of homelessness in decision and policymaking. Prevention should also be incorporated into the response to rural homelessness through intersectoral collaboration and upstream policies that target the structural drivers of homelessness. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
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39. Influence of the COVID‐19 pandemic on executive skills in Canadians experiencing social vulnerability: A descriptive study.
- Author
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Benzies, Karen M., Perry, Robert, and Cope Williams, Jessica
- Subjects
EXECUTIVE function ,RESEARCH ,SOCIAL support ,PSYCHOLOGICAL vulnerability ,CROSS-sectional method ,RESEARCH methodology ,GOVERNMENT regulation ,CONSUMER attitudes ,ACTIVITIES of daily living ,UNCERTAINTY ,SOCIAL context ,SOCIAL worker attitudes ,HEALTH ,INFORMATION resources ,DESPAIR ,DESCRIPTIVE statistics ,SOCIAL services ,PSYCHOLOGICAL adaptation ,TIME management ,MEDICAL appointments ,EMOTION regulation ,STAY-at-home orders ,PUBLIC welfare ,THEMATIC analysis ,COVID-19 pandemic ,BEHAVIOR modification ,PSYCHOLOGICAL stress ,MENTAL illness ,THERAPEUTIC alliance - Abstract
The objective of this study was to describe executive skills in clients experiencing social vulnerability in the context of COVID‐19 from the perspective of social service agency staff. COVID‐19 has required transformational changes to livelihood and day‐to‐day living. Socially vulnerable individuals are likely to be disproportionally impacted because many have experienced serious early childhood adversity, which may compromise their executive skills in adulthood. Using a cross‐sectional survey, we collected data between 05 May 2020 and 03 July 2020, for this mixed methods study of 53 staff in two agencies in western Canada serving clients experiencing social vulnerability. The first case of COVID‐19 in this jurisdiction was identified 05 March 2020. Using investigator‐designed survey items, we captured executive skills in five areas: (a) planning tasks of daily living, (b) managing time, (c) keeping track of information and appointments, (d) managing emotions, and (e) managing self‐control. Staff reported their clients struggled with executive skills and these struggles increased during COVID‐19, particularly in the areas of managing daily tasks and emotional regulation. COVID‐19 restrictions overwhelmed clients with the decisions required to maintain health, employment, and childcare. With the loss of structure and routine, clients lost track of time and delayed completion of tasks, which further increased stress. Disrupted goals and uncertainty about the future contributed to hopelessness for clients who were trying to regain control over their lives, which made it difficult to manage emotions. Some clients acted more impulsively because of the added stressors, lack of routine and access to friends and extended family. A better understanding of the impact of COVID‐19 on socially vulnerable clients will inform social service agencies about areas to focus programming to support their socially vulnerable clients. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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- View/download PDF
40. Moral distress experienced by community service providers of home health and social care in Ontario, Canada.
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Webber, Jodi, Trothen, Tracy J., Finlayson, Marcia, and Norman, Kathleen E.
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HOME care services ,SOCIAL workers ,RESEARCH methodology ,COMMUNITY health services ,INTERVIEWING ,QUALITATIVE research ,THEMATIC analysis ,PSYCHOLOGICAL distress ,PSYCHOLOGICAL resilience - Abstract
Moral distress occurs when one knows a morally correct action to take but feels powerless to act the way one believes is right. Moral distress has been studied in many contexts but there remains a gap in our understanding of the phenomenon as it manifests outside of hospital‐based settings. The aim of this study was to explore the nature of the moral distress experience among community‐based health and social care professionals working with older adults and their caregivers. Using a qualitative constructionist design, we interviewed 24 participants from a single health authority in southwestern Ontario, Canada. Participants were both urban and rurally based. Data were collected in the winter and summer of 2020 and analysed using Braun and Clarke's thematic analysis strategy. Three factors: reluctant clients, human resource shortages and system challenges, contributed to the creation of perceived morally precarious care plans, resulting in symptoms of moral distress. Study participants described frustration, guilt, anger, and grief at not being able to act consistently with their core values and provide the amount and/or quality of care their clients and unpaid caregivers deserved. We consider possible reasons for our finding that community service providers did not always respond to the consequences of moral distress symptoms in a manner similar to those in acute care contexts. Our findings suggest that study participants may have been able to cultivate moral resilience in the face of moral distress through the positive reframing of adversity and therefore maintain their overall sense of moral integrity. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
41. Community‐based responses to loneliness in older people: A systematic review of qualitative studies.
- Author
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Noone, Catrin and Yang, Keming
- Subjects
ONLINE information services ,PSYCHOLOGY information storage & retrieval systems ,SYSTEMATIC reviews ,COMMUNITY health services ,LONELINESS ,INTERPERSONAL relations ,AUTONOMY (Psychology) ,PSYCHOLOGICAL adaptation ,MEDLINE ,HEALTH promotion ,ELDER care ,SOCIAL integration ,OLD age - Abstract
In many countries across the world, older people are one of the groups most vulnerable to loneliness. Community‐based responses are well placed to support and enhance pre‐existing coping strategies in older people. However, the evidence base of these responses remain scattered and obscured, particularly in relation to their design and reasons behind their success. In this systematic review, we focus on qualitative studies on community‐based responses to loneliness among older people to learn how these responses work in practice with in‐depth details. At the end of a systematic searching and screening process, 17 studies conducted in five countries (Australia, Canada, New Zealand, Spain and the UK) published in English were selected and reviewed initially in October 2020 and then updated at the end of August 2021. Three themes were identified as being most valuable to addressing loneliness in a specific community, namely, autonomy, new social connections, and belonging. These interventions were also employed according to three primary considerations: what the community lacked, how that community experienced loneliness, or a combination of both. Several implications for policymakers and future research emerged, urging future interventions to take a more contextual approach that encompasses community‐level considerations before establishing a user‐led and tailored setting that facilitates social engagement. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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42. Relationships between Canadian adult cancer survivors' annual household income and emotional/practical concerns, help‐seeking and unmet needs.
- Author
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Nicoll, Irene, Lockwood, Gina, Longo, Christopher J., Loiselle, Carmen G., and Fitch, Margaret I.
- Subjects
TUMOR treatment ,CANCER patient psychology ,REPORTING of diseases ,OCCUPATIONAL roles ,CROSS-sectional method ,HELP-seeking behavior ,RE-entry students ,INCOME ,SURVEYS ,COLORECTAL cancer ,DESCRIPTIVE statistics ,QUESTIONNAIRES ,RESEARCH funding ,EMOTIONS ,INFORMATION needs ,DATA analysis software ,EMPLOYMENT reentry ,MEDICAL needs assessment ,BREAST tumors ,EVALUATION - Abstract
The objective of this study was to explore the relationship among income and emotional/practical concerns, help‐seeking and unmet needs for cancer survivors aged 18 to 64 years one to three years after treatment. A cross‐sectional survey was mailed in 2016 to 40,790 survivors randomly selected from 10 Canadian provincial cancer registries. Thirty‐three percent responded. A trend analysis was conducted for survivors most likely to be in the workforce exploring the relationship across four income levels and emotional/practical concerns, whether help was sought for identified concerns, and whether help was received. A total of 4,264 respondents, aged 18–64, provided useable data with breast (34.4%) and colo‐rectal (15.0%) accounting for the primary cancer type and 32.0% reporting annual household incomes of <$50,000. More than 94% of respondents indicated having emotional or practical concerns. Between one‐third and one‐half of the respondents sought help for their concerns and, of those, between one‐third and one‐half experienced difficulty finding help or did not obtain assistance. Significant trends across income categories indicated greater percentages of those in lower income categories experienced emotional and practical concerns, rated their concerns as 'big', sought help, and had difficulty finding help to address their concerns. Clearly adult cancer survivors experience emotional and practical concerns. Healthcare professionals have important roles monitoring these concerns and connecting those who desire help to relevant services. Opportunities should be given to individuals, regardless of income level, to indicate if they have concerns and if they would like assistance. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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43. Exploring French Canadian high school students' interest in and perspectives of a career with older adults.
- Author
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Dupuis‐Blanchard, Suzanne, Thériault, Danielle, and Caissie, Julie
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VOCATIONAL guidance ,FOCUS groups ,FRENCH-Canadians ,RESEARCH methodology ,ATTITUDES toward aging ,INTERVIEWING ,QUALITATIVE research ,AGING ,RESEARCH funding ,STUDENT attitudes ,STATISTICAL sampling ,CONTENT analysis ,THEMATIC analysis ,HIGH school students ,ELDER care - Abstract
For the next 30 years, population aging will impact many facets of our society. Of specific concern is future human resources in the aging sector and related health fields. Every year, high school students make decisions related to their future careers, but few express interests in a career in aging. The goal of this study was to explore high school students' interest in and perspectives of a career in the field of aging. The specific objectives of the study were to identify high school students' perspectives of older adults, explore their level of interest in an aging‐related career and understand the reasons for their level of interest for a career in aging. In this qualitative descriptive study, 41 French‐speaking students in Grades 10 and 11 from an eastern Canadian province participated in a total of five focus group discussions where an educational video complemented the semi‐structured interviews. Content analysis produced four common themes: perspectives of aging and older adults, exposure to aging in school, reasons for disinterest and increasing awareness and interest. Results indicate a lack of aging content or intergenerational activities in schools, whereas students made suggestions for better integration of aging content in the school curriculum. Future research with school guidance counsellors or educators would be beneficial in understanding aging content integration and student exposure to aging. Study limitations are also presented. [ABSTRACT FROM AUTHOR]
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- 2022
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44. The health coaching competency gap – Analysis of pharmacist competency frameworks from Australia, Canada, New Zealand the United Kingdom and the United States of America.
- Author
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Singh, Harjit K., Kennedy, Gerard A., and Stupans, Ieva
- Subjects
HEALTH education ,OCCUPATIONAL roles ,CURRICULUM ,CLINICAL competence - Abstract
The traditional competency frameworks for coaches, the International Coaching Federation (ICF) and the European Mentoring and Coaching Council (EMCC) disregard the differences in expertise required among the diverse professions that may provide coaching. A recent systematic review has identified competencies specific to health professionals who health coach. There are increasing workload pressures in primary care; pharmacists can potentially shift to the greater provision of health promotion services, such as health coaching. The provision of such services needs to be underpinned by competency frameworks, which support the role of pharmacists as health coaches. This analysis identifies the competency gaps for pharmacists if they are to take on the role of health coaching. The enabling competencies of health coaches were compared to the competency frameworks of pharmacists from Australia (AUS), Canada (CAN), New Zealand (NZ), the United Kingdom (UK) and the United States of America (USA). Correlations between the international pharmacist competency frameworks and the competencies enabling health coaching showed that entry to practice pharmacists from AUS, CAN and NZ all require training enabling the health coaching competency 'demonstrates confidence', whereas competency frameworks for pharmacists from both the UK and the USA included all competencies required to health coach. Although pharmacists from the countries examined had most of the competencies required to health coach, gaps within the international pharmacist competency frameworks were apparent, university curricula addressing these gaps would equip entry to practice pharmacists with the knowledge and understanding to confidently provide emerging professional pharmacy services such as health coaching. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
45. Advancing recovery education for people experiencing housing instability: A qualitative analysis of service user and provider perspectives in Canada.
- Author
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Khan, Bushra M., Reid, Nadine, and Stergiopoulos, Vicky
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CONVALESCENCE ,ATTITUDES of medical personnel ,RESEARCH methodology ,STAKEHOLDER analysis ,CONSUMER attitudes ,INTERVIEWING ,QUALITATIVE research ,EXPERIENCE ,DESCRIPTIVE statistics ,HOMELESSNESS ,THEMATIC analysis - Abstract
The recovery paradigm is increasingly being adopted within mental health services internationally, to support a process of personal change for affected individuals, with the aim of living a satisfying, hopeful, contributing life within the limitations of mental illness. In efforts to assist the process of recovery, Recovery Education Centres (REC), offering recovery supports through education rather than traditional service models, have been widely implemented; there is limited evidence to date with respect to the experiences and outcomes of disadvantaged populations, such as people experiencing homelessness, with recovery education. This study used qualitative methods to explore the perspectives and experiences of service users and providers of the Supporting Transitions and Recovery (STAR) Learning Centre in Toronto, Canada, focused on supporting the process of recovery for individuals with histories of homelessness. Between July 2017 and June 2018, semistructured interviews with 20 service users, one key informant, and a focus group comprising eight current and former REC staff and volunteers were conducted to explore opportunities to better tailor the curriculum, and key programmatic features, to the needs of the population. Interviews were analysed using inductive thematic analysis. Most participants described favourable experiences with the REC and suggested adding more challenging course content (n = 10) and increasing delivery options (n = 8), highlighting the diversity of participant needs. Others described the importance of improving accessibility through geographic expansion, offering transit subsidies, and using innovative media. In addition, the importance of delivering more courses in partnership with community partners, to maximise reach and impact, was also highlighted (n = 15). This study underscores the importance of engaging service users and providers, including peers, in ongoing adaptations to best serve the target populations. The expertise and lived experience of these key stakeholders offer a unique lens, supporting the process of recovery, through co‐production of curriculum content and joint program planning and improvements. Findings can inform REC development for disadvantaged populations and potentially enhance recovery outcomes for those experiencing multiple barriers to recovery. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
46. The process of commitment to exercise among stroke survivors in Canada.
- Author
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Evans, Nicole, Connelly, Denise M., and Hay, Melissa E.
- Subjects
EXERCISE & psychology ,GROUNDED theory ,INTERVIEWING ,PHYSICAL activity ,STROKE patients ,INDEPENDENT living ,QUALITY of life ,STATISTICAL sampling ,THEMATIC analysis - Abstract
The objective of this research was to understand the process of commitment to exercise participation for functional recovery among community‐living survivors of stroke following discharge from formal rehabilitation. Participants were recruited from a mid‐sized city in south‐western Ontario, Canada. Between September 2017 and March 2018, 10 individuals living in the community with the effects of stroke, who continued to engage in regular exercise post‐stroke, were recruited for participation. Constructivist grounded theory methodology was employed, utilising in‐depth individual interviews and theoretical sampling, whereby data collection and analysis occurred simultaneously. Analysis involved constant comparison between data and codes to reduce knowledge gaps and formulate the proposed theory. The process of commitment to exercise involved four phases. Initiation of the process followed a significant interaction with a healthcare provider who advocated for participants to learn the foundations of exercise. Through planned exercise, maintenance of a positive attitude and comparisons with their pre‐stroke selves and peers, participants identified future goals and imparted the desire to get back to life before stroke. Over time individuals navigated exercise opportunities—trialling different types and environments—to learn what works. Finally, participants developed a commitment to exercise as a way of life, supported by social connections and reinforced with pride in successes—mastering self‐care skills, improved mobility and meaningful function. The process of commitment to exercise among survivors of stroke required early interactions with healthcare providers to initiate exercise participation for long‐term engagement, and navigation through various exercise elements fuelled by a desire to reconnect with their pre‐stroke selves. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
47. Exploring patient centredness, communication and shared decision‐making under a new model of care: Community rehabilitation in canada.
- Author
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Manhas, Kiran Pohar, Olson, Karin, Churchill, Katie, Miller, Jean, Teare, Sylvia, Vohra, Sunita, and Wasylak, Tracy
- Subjects
MUSCULOSKELETAL system diseases ,FOCUS groups ,NEUROLOGICAL disorders ,ATTITUDES of medical personnel ,AUDIT trails ,RESEARCH methodology ,CHRONIC diseases ,PATIENT-centered care ,COMMUNITY health services ,INTERVIEWING ,PATIENTS' attitudes ,ETHNOLOGY research ,DECISION making ,COMMUNICATION ,RESEARCH funding ,DESCRIPTIVE statistics ,REHABILITATION ,THEMATIC analysis - Abstract
Patient‐centred care and patient engagement in healthcare and health research are widely mandated by funders, health systems and institutions. Increasingly, shared decision‐making (SDM) is recognised as promoting patient‐centred care. We explore this relationship by studying SDM in the context of integrating novel patient‐centred policies in community rehabilitation. There is little research on SDM in rehabilitation, and less so in the critical community context. Patient co‐investigators led study co‐design. We aimed to describe how patients and providers experience SDM at community rehabilitation sites that adopted a novel, patient‐centred Rehabilitation Model of Care (RMoC). Guided by focused ethnography, we conducted focus groups and interviews. Patient and professional participants were recruited from 10 RMoC early‐adopter community rehabilitation sites. Sites varied in geography, patient population and provider disciplines. Patient and community engagement researchers used a set–collect–reflect method to document patient perspectives. Researchers captured provider perspectives using a semi‐structured question guide. We completed 11 focus groups and 18 interviews (n = 45 providers, n = 17 patients). We found that most early‐adopter providers spoke in a shared, patient‐first language that focused on patient readiness, barriers and active listening. Congruent patient perceptions reflected inclusion in decision‐making, goal setting and positive relationships. Many patients queried how care would become and remain accessible before and after community rehabilitation care respectively. Remaining connected while in the community was described as important to patients. Providers identified barriers like time, team dynamics and lack of clarity on the RMoC aims, which challenged the initiative's long‐term sustainability. Policy innovations can promote SDM and communication through multiple strategies and training to facilitate candid, encouraging conversations. Sustainability of SDM gains is paramount. Most providers moved beyond tokenistic engagement, but competing responsibilities and team member resistance could thwart continuity. Further research is needed to empirically assess respectful and compassionate communication and SDM in community rehabilitation long term. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
48. Assessing resiliency in Canadians experiencing social vulnerability: Psychometric properties of the CUPS Resiliency Interview Schedule and Resiliency Questionnaire.
- Author
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Perry, Robert, Ginn, Carla, Donnelly, Carlene, and Benzies, Karen
- Subjects
MEDICAL quality control ,EXPERIMENTAL design ,CONFIDENCE intervals ,EVALUATION of human services programs ,RESEARCH evaluation ,PSYCHOLOGICAL vulnerability ,RESEARCH methodology evaluation ,RESEARCH methodology ,SOCIAL factors ,MENTAL health ,INTERVIEWING ,HEALTH outcome assessment ,PSYCHOMETRICS ,MULTITRAIT multimethod techniques ,T-test (Statistics) ,SOCIAL isolation ,QUESTIONNAIRES ,RESEARCH funding ,DESCRIPTIVE statistics ,FACTOR analysis ,PEOPLE with disabilities ,POVERTY ,SOCIAL skills ,STATISTICAL correlation ,DATA analysis software ,SOCIAL services ,PSYCHOLOGICAL resilience ,MENTAL illness ,COMPULSIVE behavior ,PSYCHOLOGICAL factors - Abstract
Deficit models of care for clients experiencing social vulnerability have become increasingly unsustainable; and there is a shift towards models of care that promote and protect resiliency for lifelong health. We defined clients as socially vulnerable if they were living with poverty, mental health problems and addictions, disability, and social isolation. Scales to measure outcomes of resiliency‐focused programming have limited reliability and have not been validated with vulnerable populations. The aim of this study was to develop and conduct preliminary psychometric assessment of two measures: CUPS (formerly Calgary Urban Project Society) Resiliency Interview Schedule (RIS) and Resiliency Questionnaire (RQ) for adults experiencing social vulnerability. To engage clients who were seeking integrated services at a social services agency, we developed the RIS and accessed data collected between April 2017 and December 2018. In a structured intake interview, the client and staff prioritised goals and identified resiliency in three domains: (a) economic, (b) social‐emotional, and (c) health. On average, clients (N = 545) who completed the CUPS‐RIS were 45.9 years old (SD = 12.62). For the CUPS‐RIS, Cronbach's alphas at intake and outcome assessments were 0.80. Exploratory factor analysis demonstrated a four‐factor solution with two unexpected results: executive functioning/self‐regulation loaded with mental and physical health, and client education failed to load on any factor. We found significant improvements between client intake and outcome measurement points on eight of 12 sub‐domains. As a brief self‐report measure of resiliency, we developed the CUPS‐RQ and accessed data collected between November 2018 and May 2019. Clients (N = 29) who completed the CUPS‐RQ concurrently with the Resilience Research Centre‐Adult Resilience Measure (RRC‐ARM) were, on average, 42.46 years old (SD = 12.87). The CUPS‐RQ was correlated with RRC‐ARM, r = 0.819. In preliminary psychometric assessment, the CUPS‐RIS and CUPS‐RQ demonstrated satisfactory reliability and validity and show promise as measures of resiliency for agencies serving clients experiencing social vulnerability. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
49. Predictors of change in housing status over 12 months among individuals using emergency shelters, temporary housing or permanent housing in Quebec, Canada.
- Author
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Kaltsidis, Gesthika, Grenier, Guy, Cao, Zhirong, Bertrand, Karine, and Fleury, Marie‐Josée
- Subjects
EMERGENCIES ,AGE distribution ,CONCEPTUAL structures ,CIVILIAN evacuation ,RESEARCH funding ,HOUSING ,PUBLIC welfare ,LOGISTIC regression analysis - Abstract
Homelessness is an ongoing societal and public health problem in Canada and other countries. Housing services help homeless individuals along the transition towards stable housing, yet few studies have assessed factors that predict change in individual housing trajectories. This study identified predictors of change in housing status over 12 months for a sample of 270 currently or formerly homeless individuals using emergency shelters, temporary housing (TH) or permanent housing (PH) resources in Quebec. Participants recruited from 27 community or public organisations were interviewed between January and September 2017, and again 12 months later. Sociodemographic variables, housing history, health conditions, service use and client satisfaction were measured. Directors and programme coordinators from the selected organisations also completed a baseline questionnaire measuring strictness in residential codes of living/conduct, interorganisational collaboration and overall budget. Independent variables were organised into predisposing, enabling and needs factors, based on the Gelberg‐Andersen Behavioral Model. Multilevel logistic regressions were used to test associations with the dependent variable: change in housing status over 12 months, whether positive (e.g. shelter to TH) or negative (e.g. PH to shelter). Predictors of positive change in housing status were as follows: residing in PH, being female, having children (predisposing factors); having consulted a psychologist, higher frequency in use of public ambulatory services (enabling factors); and not having physical illnesses (needs factor). The findings support strategies for helping this clientele obtain and maintain stable housing. They include deploying case managers to promote access to public ambulatory services, mainly among men or individuals without children who are less likely to seek help; greater use of primary care mental health teams; the establishment of more suitable housing for accommodating physical health problems; and reinforcing access to subsidised PH programmes. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
50. Investigating the cyclical hypothesis of client aggression as a 'loss spiral': Can child protection worker distress lead to more client aggression?
- Author
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Lamothe, Josianne, Geoffrion, Steve, and Guay, Stéphane
- Subjects
WORK environment ,VIOLENCE in the workplace ,PSYCHOLOGICAL burnout ,WORK experience (Employment) ,SOCIAL support ,PSYCHOLOGY of social workers ,CHILD welfare ,QUESTIONNAIRES ,JOB satisfaction ,DESCRIPTIVE statistics ,AGGRESSION (Psychology) ,SOCIAL services ,VICTIMS ,PSYCHOLOGICAL distress ,LONGITUDINAL method - Abstract
Working in a stressful environment, child protection workers (CPWs) are often victims of psychological and physical acts of aggression perpetrated by their clients. This can be emotionally distressing for CPWs. Previous authors have suggested that this distress could place CPWs at greater risk for subsequent victimisation if they become emotionally unavailable to their clients. This study sought to investigate whether the distress experienced after an act of client aggression or other types of potentially traumatic events could indeed predict subsequent victimisation over time. Using cross‐lagged panel analysis, researchers administered standardised questionnaires to 173 CPWs who had experienced an act of client aggression or other type of potentially traumatic event in the month prior. Participants were asked to fill out additional questionnaires 2, 6 and then 12 months later. Researchers found that CPW distress did in fact predict subsequent victimisation at the 2‐month time point only. Researchers then conducted a generalised linear model analysis to test the influence of sociodemographic variables and the moderating influence of supervisor support. Supervisor support did not moderate the relationship between initial distress levels and increased aggression 2 months later. The study concludes by examining how the emotional distress of CPWs can negatively impact clients and how organisations can best provide support, in part, by rethinking aggression prevention. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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