2019-2020 Honors Students
Autumn Beemer & Iva Piplica
Study: Quality of Life Assessments in Dementia Care: A Proposal for Integrative Review
Background: Dementia frequently impacts the quality of life (QOL) of individuals affected by the illness. Assessment of QOL allows for the perspectives of individuals living with dementia to be heard by their healthcare providers and caregivers. There is a lack of knowledge translation (KT) tools for healthcare providers and family caregivers on how to approach QOL assessments in individuals living with dementia. This has limited their use in the care of this population.
Aim:
- To better understand how and when individuals with dementia self-report QOL using patient-reported outcome measures (PROMs), how PROMs are to be collected in the event of proxy assessment for individuals living with dementia, and how PROM results (both self-report and proxy) are to be used in dementia care; and>
- To develop two KT tools to support the use of QOL assessments for people living with dementia – one tool for healthcare providers and one tool for family caregivers.
Methods: We will use an integrative review to synthesize existing reviews and syntheses to inform the development of two KT tools.
Conclusion: The KT tools will be reviewed by an International Research Team before being finalized and made publicly available to healthcare providers and family caregivers of individuals living with dementia.
Charlotte Cattanach & Isabella Rees
Supervisor: Dr. Elisavet Papathanassoglou
Study: Non-Pharmacological Interventions for Autonomic Dysfunction in Critical Illness: A Rapid Review
Abstract: In the intensive care unit (ICU), critically ill patients are faced with overwhelming physiologic and psychological stressors, triggering a sustained stress response. Prolonged activation of the sympathetic nervous system results in decreased parasympathetic tone, and is possibly associated with autonomic nervous system dysfunction (ANSD) in prolonged critical illness. ANSD compromises multiple body systems, and is a strong predictor for death in critically ill patients. Many non-pharmacological interventions (NPI) have been explored with regard to their effect on decreasing stress and stimulating the parasympathetic nervous system. This review will systematically examine the potential effects of NPI on the regulation of autonomic function in the ICU, and anticipates identifying gaps in the literature, as well as methodological considerations for future studies. A rapid review will be conducted via MEDLINE, CINAHL, TRIP, Embase and Cochrane Library searches to identify interventional studies exploring the effect of NPI on ANSD, based on predefined inclusion and exclusion criteria. Screening of the literature will be completed by two independent reviewers, and quality of studies will be critically appraised by the Cochrane Collaboration tool for risk of bias. Data will be extracted based on a predetermined extraction table, results will be critically synthesized, and potential clinical implications will be discussed.
Erica Shin
Study: Research Utilization and Psychological Empowerment
Abstract: Approximately 300,000 older Canadians currently live in residential long-term care homes, with this number projected to continuously rise over time. Such statistics demonstrate care aides’ pivotal role in providing direct care to residents, thus they have the opportunity to improve the quality of care and well-being of residents. It is imperative that health care aides incorporate research utilization in their care. There is currently limited research on research utilization among health care aides, however literature supports that psychological empowerment is a potential mechanism to increase research utilization among health care aides. Research utilization and empowerment are indirectly related through job satisfaction and positive attitude. When health care aides are psychologically empowered through increased positive attitude and job satisfaction, they are more likely to adapt research utilization in their practice. The aim of this study is to assess the association between care aides’ psychological empowerment and research utilization in long-term care facilities, and how research utilization may impact quality of care.
This is a quantitative cross-sectional analysis of secondary data collected by the Translating Research in Elder Care (TREC) research program from September 2019 to February 2020 across 93 long-term care facilities in Western Canada.
Jenna Macklin & Ariadna Rolo Codorniu
Supervisor: Dr. Olga Pertrovskaya
Study: e Role of Electronic Personal Health Records and Patient Portals in the Management of Chronic Respiratory Conditions: a Protocol and a Scoping Review
Background: In November 2019, Alberta Health Services launched a province-wide clinical information system, Connect Care, which implements an electronic patient portal. Online portals allow patients to access their personal health information. Empirical research indicates positive effects of patient portals for patients living with chronic respiratory illness (eg, asthma, COPD) such as improved symptom management and well-being. However, there are no reviews summarizing evidence on the effects/outcomes of patient portals for patients with asthma or COPD and for health service provision. To address this gap, we have designed a scoping review of the effects of patient portals in this understudied clinical area.
Research question: For chronic respiratory conditions such as asthma and COPD, what are the effects of Personal Health Records and Patient Portals on patient and health provider experiences, and clinical and health system outcomes? Design. The Joanna Briggs Institute Scoping Review methodology modified by Tricco et al. (2018).
Methods and analysis: We searched electronic databases using a rigorous search strategy. Three reviewers independently screened titles, abstracts, and full texts, applying inclusion and exclusion criteria. Studies that address tethered or stand-alone personal health records and/or patient portals in the context of chronic respiratory disease management were included (n=25). Data extraction and analysis will be guided by a theoretical framework (ie, four mechanisms explaining how portals help achieve positive outcomes; Otte Trojel et al 2014).
Ethics and dissemination: Human ethics approval is not required since this review encompasses
only published data. We will publish a protocol and completed scoping review in peer-reviewed
journals to inform future studies and clinical practice in Alberta and beyond.
Jessica Gonzalez
Supervisor: Dr. Jude Spiers
Study: Linguistic Practices and Diabetes
Abstract: An individual’s experience living with diabetes changes daily, and how an individual feels about their diabetes evolves throughout their lives. The purpose of this focused analysis research project is to explore the use of linguistic practices such as metaphors, similes, sarcasm, humour and jokes that individuals who live with diabetes and who manage with an insulin pump, utilize to describe their experiences and diabetes practices. The data set consists of 30 interviews from 15 participants who live with either Type 1 or Type 2 diabetes. These participants all live in Newfoundland and Labrador. I will use inductive content analysis, including open coding, in vivo coding, and categorization to identify essential linguistic practices, their implied meaning in the conversation, intended audience, and conversational consequences in the interviews. Understanding more about how people with diabetes express their experience will give insight into how an individual perceives their self-management practices and their relationship with their diabetes in different contexts. This, in turn, may aid nurses in identifying linguistic indicators that need to be followed up in conversation to illuminate the challenges and stigma people may face in living with their diabetes.
Joanna Trieu, Danielle Lysak, & Kathryn Palamarek
Study: Nursing Students’ Awareness and Utilization of Educational and Professional Resources Towards Informatics Competency Development
Abstract: Despite extensive research on integration of informatics in formal nursing education, little is known about professional and educational resources students’ use and their perspectives as to how these resources help them acquire informatics competency during undergraduate nursing education. This study aims to explore nursing students’ awareness and utilization of educational and professional resources available to support nursing informatics competency development. A secondary aim is to compile a list of accessible resources that could be used to augment learning about informatics at the undergraduate level. An exploratory descriptive survey method with a few open-ended questions will be used. REDCap survey data management tool will be used to disseminate an anonymous survey to undergraduate nursing students enrolled in the University of Alberta’s Faculty of Nursing in Edmonton and its Collaborative programs including Red Deer, Augustana Campus, Keyano, and Grand Prairie. Data collection will commence in June following ethics approval from the Ethics and Research Board at the University of Alberta and administrative approvals to access study population. Descriptive statistics will be used to summarize and describe the data using SPSS version 25.0. Content analysis will also be used to analyze responses to open ended questions.
Lydia Mutoni & Ramya Sridhar
Abstract: In Canada, one in five people will experience a mental illness in their lifetime. Access to mental health care can be costly, difficult to find and limited due to their location. For people with a chronic and persistent mental illness (CPMI) accessing mental health care can be even more challenging due to their mental illness; for example, someone who experiences paranoid delusions will struggle to connect with and regularly visit a healthcare provider. These challenges are even more evident at the end of life. The purpose of this research is to develop a model of care for people with CPMI at the end of life. This project is the second phase of a three-phase study. The first phase involved understanding the perspectives of Health Care Providers working in PEOLC and phase three will involve understanding the perspectives of people living with a mental illness and their families. This second phase is focused on understanding the perspectives and experiences of health care professionals working in mental health settings. This qualitative study uses an interpretive description (ID) methodology. This approach was developed to satisfy the unique requirements of nursing science by emphasizing that research must be relevant and transferable to nursing practice. Purposive and snowball sampling will be used to recruit 20-25 participants within Edmonton that have mental health care experience for semi-structured interviews. We will be recording and transcribing interviews for inductive thematic analysis. Results from phase two will be combined with phase one and three to develop a model of care that is relevant to nursing practice. This model will be used to guide PEOLC-specific care for patients with a CPMI and advanced illness.
Mariya Pakina & Melissa Ung
Supervisor: Dr. Connie Varnhagen
Study: Animal Companionship and Mental Well-being in Individuals with Substance Abuse
Abstract: Individuals with substance abuse face many difficulties, which may include impacts to their mental well-being. Companion animals can be used as a source of unconditional love and support in individuals who find their pets to be important in their life and to their well-being. In this study, we will look at the contribution of animal companionship to the mental well-being of individuals with substance abuse. Our study will be a mixed-methods study, containing both quantitative and qualitative components. The quantitative portion will consist of two surveys, Lexington Attachment to Pets Scale (LAPS), and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). We will analyze the two scales to determine if there is a correlation between an individual’s well-being and their attachment to their pet(s) using the Spearman’s rho test. The qualitative portion will be performed through participants answering open-ended questions online about their view on how their pet impacts their mental well-being. This portion will be analyzed by pulling out different themes and coding them through the use of NVivo software. The setting for both portions will take place online through the use of Google forms. The role of pets for an individual’s well-being with substance abuse has not been well studied. There is a need for non-pharmacological management of mental well-being, as well as an understanding of the holistic view of the human animal bond in individuals with substance abuse.
Melina Lee
Supervisor: Dr. Joanne Olson
Study: Military Parents’ Experiences of Resilience Enhancing Training: A Qualitative Analysis
Background: Military families are at an increased risk of experiencing the impacts of the military member’s operational stress injuries. These situations require extreme resilience on the part of military families as a whole cohesive unit, thus research on enhancing resilience as an intervention is important for this vulnerable population.
Purpose: The purpose of this study is to understand the experiences of Canadian military parents with children 8 years old and under who are enrolled in resilience enhancing training in terms of perceived family well-being.
Research questions: What are military parents’ experiences of a resilience enhancing training program on family well-being? Sub-questions include: 1) How do parents in the military context experience the resilience enhancing training in relation to their ability to manage stressful events in their lives? 2) How do parents in the military context experience the resilience enhancing training in relation to their ability to assist their children manage stressful events in their lives? 3) How do parents in the military context perceive the transferability of the skills taught in the resilience enhancing training program across family members?
Design: A qualitative descriptive thematic analysis will be performed on focus group interviews that occur at least a minimum of 6-weeks post-resilience enhancing training program.
Methods: Participants will be contacted to participate in the project-end focus group interviews. NVivo will be used to store, organize, analyze and categorize transcribed interview data and will be subjected to thematic analysis.
Anticipated Outcomes: Knowledge gained from this research is anticipated to advance understanding and open new opportunities about beneficial, accessible and affordable training programs for military parents, and their role in promoting family resilience.
Laiba Rizwan & Michelle Malagon
Supervisor: Dr. Solina Richter
Study: Understanding the Influence of Ghanaian Women’s Migration on Access to Healthcare
Background: The feminization of migration stimulates female empowerment, provides improved employment opportunities, and promotes cultural diversity; all while simultaneously exposing women to detrimental conditions that impose risks to their physical and psychological well-being.
Purpose: Perform a secondary analysis to explore how the social determinants of health (SDoH), specifically socioeconomic status (SES), culture, and education, impact the access to healthcare of Ghanaian women who have migrated internally in Ghana or externally to Canada.
Method and analysis: The data of 2 primary focused ethnographies [Richter, Vallianatos, & Toosi (2017-2020) and Vallianatos, Richter, Ansu Kyeremeh, & Aniteye (2014-2015)] will be analyzed using thematic analysis while implementing an intersectionality approach. The datasets in the primary studies consisted of interview transcripts collected from Ghanaian women migrating within Ghana and those migrating to Canada; a total 14 transcripts will be analyzed from subsamples. The primary studies conducted by our research supervisor, Dr. Solina Richter, focus on assessing the impact of intersectionality on health beliefs and practices, as well as their access to healthcare.
Ethics: The primary studies received ethical approval via the Human Research Ethics Review Board at the University of Alberta, Canada; an ethics application has been submitted to obtain approval for the secondary analysis.
Anticipated outcomes: Our findings will serve as a foundation in improving access to health services and developing competent nursing practice for female migrant populations. The outcomes will be disseminated via manuscripts, as well as oral and poster presentations through multiple platforms, prompting further research on migrant health.
Muriel Valenzuela & Mikayla Lindsell
Supervisor: Dr. Matthias Hoben
Study: A Systematic Review on the Relationship Between Care Staffing and Quality Outcomes in Assisted Living and Home Care
Background: The proportion of seniors in Canada, as well as their average age, is projected to increase significantly over the next few decades. In 2014, over 6 million Canadians were aged 65 years or older, representing 15.6% of Canada's population, but by 2030, it is expected that the population of seniors will reach over 9.5 million, making up 23% of Canadians. Aging is the leading risk factor for dementia and cognitive decline, therefore the increasing number of people with dementia and their increasingly complex care needs have raised pressures on healthcare systems and have major implications for nursing staff resources. Due to the continued growth in home and community-based services and the increasing number of older adults with chronic conditions, the demand for nurse staffing resources will likely increase correspondingly. Currently, there is little evidence that care staffing resources in community- based settings have responded adequately to these trends. This raises concerns that vulnerable residents may be at an increased risk for poor quality of care and quality of life.
Objective: The objective is to identify, evaluate and synthesize evidence on care staffing resources in assisted living and home care and how staffing resources affect (a) quality of client care, (b) client or family/friend caregiver quality of life, and (c) care staff quality of work life.
Design: We will conduct a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement and by the Cochrane Handbook for Systematic Reviews.
Methods: Using a comprehensive search strategy, we will search the databases MEDLINE, Embase, Evidence Based Reviews—Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Scopus, and PsycInfo. Two independent reviewers will screen title and abstract. Full text screening will be performed by two independent reviewers. For included articles, quality appraisal and data extraction will be completed to rate the risk for bias and to synthesize the information in the article. At each stage, calibration exercises and quality monitoring will be done with reviewers to ensure consistency of ratings and rigour of the study methods.
Significance and Dissemination: This study will identify important research gaps to be addressed in future empirical research, which will help develop and encourage evidence-informed staffing policies and inform the development and evaluation of complex interventions to improve care staffing as well as quality outcomes.
Monique Desjarlais & Oluchi Madueke
Supervisor: Dr. Sherry Dahlke
Study: A Descriptive Qualitative Study on Engaging Nursing Students in Meaningful Education Pertaining to Gerontological Nursing Studies
Background: Evidence shows that those aged 65 and older are the greatest users of healthcare, and that nurses represent the largest number of healthcare professionals within the healthcare system. This highlights the need to understand how nursing students are learning to work with older people. Although studies identify that practicing nurses have gaps in their knowledge regarding the care of older people, these studies do not address how nursing curricula and education pertaining to gerontology needs to be improved. Conducting research surrounding nursing students’ experiences working with older people in their undergraduate nursing program, can be used to facilitate the development of learning activities to improve how student nurses are learning about older people.
Aim: To understand what undergraduate nursing students find to be meaningful education when working with older people.
Design: Descriptive qualitative analysis.
Methods: Conventional content and thematic analysis of interview transcriptions
Implication for Nursing Practice: Increased perception and willingness of graduating nursing
students to work with older people; quality improvement of geriatric education in nursing curricula; and enhancement of nursing students’ competence which will contribute to positive health outcomes for older people.
Stephanie De Dios
Supervisor: Dr. Salima Meherali
Study: Information Needs of Immigrant Youth and Adolescents Related to Sexual and Reproductive Health (SRH) Needs
Introduction: Canada is a country of immigrants and helps stimulate economic growth. In 2017, more than 300,000 immigrants moved to Canada, which is the largest number since 1971. Despite the importance of immigrants and their increasing number in Canadian society, there is still limited research on the information needs of immigrant youth and adolescent in accessing SRH services. Adolescence is a period of SRH development and interconnects with various aspects of physical, mental, and social well-being. Neglect of specific SRH needs may lead to negative SRH outcomes such as high risk sexual behaviours, dating abuse, sexually transmitted infections, improper contraceptive use, and unintended pregnancy. It is important to study this population in-depth to better understand the SRH needs of immigrant youth and adolescents, increase their access to SRH services, and improve overall SRH outcomes.
Aim and objectives: The aim of this scoping review is to explore the SRH challenges that immigrant youth and adolescents experience. Through a comprehensive perspective of their information needs, we can begin planning interventions to improve SRH outcomes, so that we can mitigate the barriers in accessing SRH services. Additionally, this study aims to identify research gaps in existing literature as well as to summarize and disseminate research findings for clinicians, immigrant service providers and policymakers.
Methods: This scoping review is guided by the methodological framework outlined by Arksey and O’Malley (2005). This study will examine the extent, range and nature of research activity in the context of immigrant youth and adolescent health. Through a scoping review, researchers can explore evidence that address and inform practice in the field and the way the research has been conducted. This methodology is particularly useful for examining a broadly covered topic, in order to comprehensively, systematically map the literature, and identify key concepts, theories, evidence, or research gaps. I will work with an experienced librarian to develop a search strategy to identify literature reporting on the information needs of immigrant youth and adolescents in accessing SRH services in Canada.
Anticipated Outcomes: The findings of this scoping review will help my research supervisor, Dr. Meherali, design a future multi-setting study to develop innovative knowledge translation strategies, for immigrant youth and adolescents to optimize adolescents SRH outcomes. Upon completion of this project, I will participate in dissemination activities which include writing a manuscript for publication in peer-reviewed journals as well as present my research findings at several conferences. Such work will be useful in guiding future research, informing public policy, and improving SRH services that meets the needs of this population.
Veronica Ruschkowski & Anastasia Yakowich
Supervisor: Dr. Carole Estabrooks
Study: The Reported Frequency of Care Aides Working Short and Pressure Ulcer Rates in Canadian Long-term Care Homes
Abstract: Quality of care in nursing homes has been an ongoing challenge, and with growing pressures on the long-term care system due to an aging population and dementia, this burden will further increase. Care aides provide the majority of direct patient care in this setting; when they work short-staffed this may negatively impact resident health and quality of life and there has been little to no research addressing this issue. The purpose of our study is to examine the correlation between care aides working short and pressure ulcers, as these are a well-researched quality indicator and are sensitive to quality of care. Translating Research in Elder Care (TREC) is a longitudinal program gathering data in Western Canadian nursing homes. We intend to utilize data from the TREC care aide survey and the Resident Assessment Instrument Minimum Data Set 2.0 to carry out a secondary analysis of cross-sectional data from a stratified random sample of 94 nursing homes in Western Canada. To assess the association between our variables, we will use descriptive and inferential statistics with multilevel modeling. Our results may inform future research and advocacy for safe staffing protocols to improve resident quality of life and care aide quality of work life.
Allison Gomez
Supervisor: Dr. Elisavet Papathanassoglou
Study: Peripheral Biomarkers Associated with the Relaxation Response: A Scoping Review Protocol
Background: Research literature highlights an expanding interest in relaxation techniques to improve well-being and patient outcomes by inducing the relaxation response. The relaxationresponse involves a decrease in the activation of the sympathetic nervous system, and subsequently, results in favorable physiological changes in the body. However, there is great heterogeneity in outcome measures across studies exploring the effects of relaxation and nostandardized approach to evaluating its physiological effects, especially at the level of peripheral mediators.
Aim: To identify all peripheral biomarkers that have been assessed in healthy individuals or individuals with any health condition in response to relaxation-inducing interventions or techniques. Secondary objectives include summarizing evidence on alterations in biomarkers in response to relaxation approaches, and any sex and gender specific differences, as well as evidence regarding validity and reliability of measurements.
Methods: Scoping review of peer-reviewed studies, based on literature searches (MEDLINE, CINAHL, Cochrane Library, Embase, PsychInfo, SCOPUS) with predefined keywords. Primary published peer-reviewed studies including participants of any age receiving a relaxation technique intervention in an experimental, quasi-experimental or mixed-method design will be reviewed. Data extraction will be guided by a pre-defined template and will be carried out by two independent reviewers. Quality appraisal will be carried out by the Cochrane tool for assessing risk of bias.
Significance: Summarizing evidence on all relaxation-related peripheral biomarkers can inform the design and outcome measures of future studies, which can contribute to congruence across studies and, subsequently, a higher level of evidence for relaxation techniques.