Linda J. Patrick

Health Behaviours of Postpartum Women with a History of Gestational Diabetes

ABSTRACT OBJECTIVES 1) To explore the health behaviours of women with recent gestational diabetes mellitus in the first year postpartum; and 2) to compare their perceived health status with their actual experiences in establishing and maintaining healthy lifestyle changes. METHODS A concurrent mixed method design using semi- structured interviews, supplemented by the Short-Form 36 (SF-36) Health Survey, diet recall and activity-level records collected at multiple intervals. RESULTS A total of 16 women rated their general health (SF- 36) as good or very good, but diets rarely met Canadas Food Guide recommendations. Narratives revealed initial experiences of abandonment and uncertainty with respect to staying healthy and moving on at 1 year. Continuing support and education postpartum were identified as being needed to maintain changes made during pregnancy CONCLUSIONS Participants acknowledged their increased risk for type 2 diabetes and were cognizant of health behaviours that might prevent diabetes; however, sustaining lifestyle changes in diet and activity were described as difficult.

Scoping review of complexity theory in health services research

BackgroundThere are calls for better application of theory in health services research. Research exploring knowledge translation and interprofessional collaboration are two examples, and in both areas, complexity theory has been identified as potentially useful. However, how best to conceptualize and operationalize complexity theory in health services research is uncertain. The purpose of this scoping review was to explore how complexity theory has been incorporated in health services research focused on allied health, medicine, and nursing in order to offer guidance for future application. Given the extensiveness of how complexity theory could be conceptualized and ultimately operationalized within health services research, a scoping review of complexity theory in health services research is warranted.MethodsA scoping review of published research in English was conducted using CINAHL, EMBASE, Medline, Cochrane, and Web of Science databases. We searched terms synonymous with complexity theory.ResultsWe included 44 studies in this review: 27 were qualitative, 14 were quantitative, and 3 were mixed methods. Case study was the most common method. Long-term care was the most studied setting. The majority of research was exploratory and focused on relationships between health care workers. Authors most commonly used complexity theory as a conceptual framework for their study. Authors described complexity theory in their research in a variety of ways. The most common attributes of complexity theory used in health services research included relationships, self-organization, and diversity. A common theme across descriptions of complexity theory is that authors incorporate aspects of the theory related to how diverse relationships and communication between individuals in a system can influence change.ConclusionComplexity theory is incorporated in many ways across a variety of research designs to explore a multitude of phenomena.. Although complexity theory shows promise in health services research, particularly related to relationships and interactions, conceptual confusion and inconsistent application hinders the operationalization of this potentially important perspective. Generalizability from studies that incorporate complexity theory is, therefore, difficult. Heterogeneous conceptualization and operationalization of complexity theory in health services research suggests there is no universally agreed upon approach of how to use this theory in health services research. Future research should include clear definitions and descriptions of complexity and how it was used in studies. Clear reporting will aid in determining how best to use complexity theory in health services research.

Empowerment and Mentoring in Nursing Academia

Abstract In 2011, there was an expected shortage of 200 full-time faculty. While there are an estimated 322 graduate students in Nurse Practitioner and Masters/PhD programs in Canada today, the supply of potential new faculty falls short of the anticipated demand in the years ahead (Canadian Association of Schools of Nursing). This mixed method study explored how organizational culture and the perceived level of psychological and structural empowerment are associated with one’s work environment among Canadian nursing faculty and to explore the state of mentorship in schools of nursing.

The Literature Review: Demystifying the Literature Search

This article provided an overview of the strategies, tools, and techniques for searching the literature. Also discussed was how to retrieve, manage, and report relevant information that has been found. There are many books and computer tutorials about each of these topics available in libraries and bookstores. It may be worth-while to investigate the availability of courses in your workplace and community for fine-tuning your search skills. A hands-on opportunity to search relevant databases under the guidance of a librarian or experienced researcher would be worth the investment. One key message is to be organized when approaching the literature. Careful planning and organization can help ensure that your research trip is a productive one.

Patient perceptions of satisfaction following diabetes education: use of the mastery of stress instrument.

PURPOSE The purpose of this study was to test the conceptual congruency of scores from the Mastery of Stress Instrument (MSI) with qualitative data in an effort to identify patients for whom a specific educational intervention was sufficient. METHODS A convenience sample of patients with diverse age and educational backgrounds was recruited from those who registered for a 4-session diabetes educational experience as new or refresher patients. All 57 patients completed the MSI before and after diabetes educational experiences, and half participated in before and after audiotaped interviews. All patients responded to a query about their perceptions of the educational experience. MSI scores were analyzed by demographic variables as well as compared to qualitative interviews for greater insights and explanation. RESULTS Consistency was noted between the MSI scores and the information revealed in the interviews. Additional support for the use of the MSI to identify patients at risk and in need of additional educational interventions was realized. CONCLUSIONS Further research to explore the use of the MSI with persons with different educational experiences and to standardize the MSI scores for adult persons taking diabetes or other patient education classes is needed before generalization can be achieved.

Reducing the “cost of caring” in cancer care: Evaluation of a pilot interprofessional compassion fatigue resiliency programme

ABSTRACT Compassion fatigue (CF) is a combination of secondary traumatic stress and burnout. Empathy becomes depleted among professional caregivers due to repeated exposure to emotional pain. Negative effects include decreased general wellbeing, impaired caregiver health and diminished team functioning. Intervention is needed to support caregiver quality of life and team relationships in high-stress work environments. This pilot study evaluated the impact of a pilot CF resiliency (CFR) programme on interprofessional staff at a regional cancer centre. An embedded experimental mixed-methods design was employed to evaluate a 6-week formalised CFR intervention. We measured CF satisfaction, burnout, clinical stress and silencing responses pre- and post-intervention. Focus group and individual interviews were conducted mid-programme and at end-programme completion to understand participants’ views about how the programme affected their experiences of CF. Qualitative and quantitative data were analysed separately and merged to produce the overall findings. Participants reported reduced clinical stress at programme completion (t = 3.5; p = .005). This finding may be explained by participants’ ability to identify signs and symptoms of CF and engage in self-care and mindfulness activities. Further larger studies are needed to evaluate the long-term effects of CFR programmes on caregiver and organisational wellbeing.