2020 2021 Honors Students

Hannah Fonteyne & Karlee Podritske

Hannah and Karlee wearing their nursing grad outfitsStudy: Hoping for Change: Why Immigrant Women Seek the Services of a Community Agency, Dr. Tanya Park & Dr. Kathleen Hegadoren

Background: Domestic violence (DV) experienced by immigrant women is a public health concern. Precarious immigration statuses, language barriers, mistrust, and discrimination can lead to reluctance in seeking support.

Purpose: To add to what is known about immigrant women who experience DV and the services they access.

Setting: Changing Together is a non-profit charitable organization and support center. Participants in this study were immigrant women who attended Changing Together. The women were from various countries, spoke multiple languages, and had varying immigration statuses.

Methods: Using thematic analysis, a file audit was conducted on 1,034 files to gain understanding of the lived experiences of immigrant women surviving DV. The narrative file notes from a social worker at Changing Together contained descriptions of immigrant women’s reasons for seeking support from the community agency and their experiences.

Findings: Three themes were developed:

  1. Laying Down Roots centres on women building solid foundations to start lives in Canada and support themselves and their families.
  2. For the Children encompasses the hardships women endured for the perceived sake of their children until there is an event leading to the unavoidable need for change.
  3. Hope for Change focuses on women who come to Canada hoping for a better future.

Conclusion: There is a need for on-going research to assist in identifying best practices from the perspective of both abused immigrant women and nurses. Further attention should be paid to the mental health needs of this population.

Eve Poblete

Eve pobleteStudy: The Lived Experiences of Pregnant Immigrant Women during the Covid-19 Pandemic: A Focused- Ethnographic Study, Dr. Solina Richter

Background: Immigrant women tend to experience more challenges after migrating and becoming pregnant in a new country. The overall unfamiliarity of Canada prevents them from accessing healthcare services, and with the current Covid-19 pandemic, new and unprecedented challenges rose and amplified the current issues of maternal and child health.

Purpose: The purpose of this study was to explore the lived experiences of Black, People of Color (BPOC) pregnant immigrant women in their child-bearing years residing in Edmonton, Alberta, Canada during the Covid-19 pandemic.

Methods: This study utilized a focused-ethnographic approach implementing thematic analysis based of the participants’ individual semi-structured interviews. There were nine participants recruited using purposive and snowball sampling techniques within the Edmonton area in partnership with the provincial health authority’s maternal health program.

Findings: Four major themes emerged:

  1. Women’s experiences of migrating to Canada,
  2. Pregnancy and birthing journey during the Covid-19 pandemic,
  3. Support and coping, and
  4. Utilization of healthcare services

Conclusion: The Covid-19 pandemic contributed to heightened anxiety and distress for immigrant women due to restrictions, outbreaks, and the lack of support during their pregnancy and post-partum period. Exploring their experiences allowed this study to make evidenced-based suggestions on how to improve healthcare services and maternal support for pregnant immigrant women in Canada.

Rebecca Sugars, Simran Virk & Vidhi Patel

Rebecca Sugar, Simran Virk & Vidhi PatelStudy: Exploring Physical Activity Guideline Adherence in Canadian Immigrant Youth from the Perspective of Community Service-Workers: A Qualitative Exploratory Study, Dr. Margot Jackson and Dr. Matthias Hoben

Introduction: Exploring Physical Activity Guideline Adherence in Canadian Immigrant Youth from the Perspective of Community Service-Workers: A Qualitative Exploratory Study
Background: The Canadian Society for Exercise Physiology (CSEP) Youth Physical Activity Guidelines are the national gold standard for youth physical activity. Minimal research exists regarding CSEP Guideline adherence in immigrant youth despite this population’s significance in Canada.

Purpose and Objectives: The purpose of this study was to foster a better understanding of physical activity guideline adherence in Canadian immigrant youth. The study objectives were to determine Canadian immigrant youth’s general adherence levels, barriers to adherence, applicable recommendations to improve adherence, and the impact of the COVID-19 pandemic on adherence.

Methods: A qualitative exploratory design was used. Purposive sampling from Edmonton community-agencies occurred to generate a sample of 6 community service-workers that have experience with Canadian immigrant youth and physical activity. Data collection occurred through virtual semi-structured interviews. Data analysis occurred via Braun and Clarke’s Six Thematic Analysis Steps.

Findings: Three primary themes emerged:

  1. Multiple Barriers to CSEP Guideline Adherence including low familiarity with physical activity, inaccessibility, finances, and competing responsibilities,
  2. Low Adherence Level to CSEP Guidelines indicating significant under-adherence that was worsened by the pandemic, and
  3. Critical Recommendations to Improve CSEP Guideline Adherence including increase accessibility, increase information/education, and promote mentorship.

Conclusion: Through a robust qualitative overview on the subject, this study can optimize nursing health promotion efforts and policies, inform health promotion protocols in nursing education, and guide further research examining subtopics that would enhance the breadth of current literature. Collectively, this study is a foundation for promoting the health of Canadian immigrant youth.

Arjun Bains & Hyelin Sung

Arjun Bains & Hyelin SungStudy: The Use of Arts-based Knowledge Translation Tools in Pediatrics: A Systematic Review, Dr. Shannon Scott

Introduction: Knowledge translation (KT) is focused on putting research to work. Arts-based KT approaches may overcome boundaries in pediatrics to increase understanding on complex health topics. Drawing on a larger systematic review, this study aims to explore the use of arts-based KT tools in pediatrics.

Methods: Two independent reviewers screened the 212 included articles from the larger review for title and abstract. Variables for analysis included study method and country, art form, Archibald Classification Schema quadrant, outcome measure types (categorized using “knowledge,” “attitude,” “behaviour,” and “clinical” labels. The larger systematic review searched 10 databases for English articles published between 1990-2020.

Results: Sixty-four studies were included. Designs of included studies were: quantitative (n=40, 62.5%), multi-methods (n=11, 17.2%), qualitative (n=9, 14.1%), and mixed-methods (n=4, 6.2%). For outcome measures, 41 studies used knowledge, 45 used attitude, 30 used behaviour, and 4 used clinical. Intervention art forms included stories (n=31), theatre (n=19), first-person narratives (n=5), Illustrations or photographs (n=7), and videos (n=2). 32 Studies (50.0%) reported positive outcome effects, 7 (10.9%) reported mixed effects, 18 (28.1%) reported unclear effects, and 7 (10.9%) reported non-significant effects.

Conclusion: Our findings indicate a similar proportion of study designs in child health compared to the broader review. However, pediatric KT tools more frequently report unclear or negative outcomes and employ behavioural outcome measures more. This study highlights the use of arts-based approaches in child health

Eunah Cha & Vidhi Vyas

Eunah Cha & Vidhi VyasStudy: Inclusion of intersectionality in studies of vaccine coverage in Canada: a scoping review, Dr. Shannon MacDonald

Background: Intersectionality refers to the coexistence of social identities that create an amalgamate disadvantage for individuals or groups. Inclusion of intersectionality in vaccine research allows healthcare professionals and policy makers to consider the constellation of individual and group characteristics that may contribute to low vaccine uptake. The objective of this scoping review is to examine the inclusion or lack thereof of intersectionality in Canadian vaccine coverage research.

Methods: The eligibility criteria included studies on immunization coverage among Canadians of all ages. Literature written only in English and French was included. The databases searched included Medline (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Library, Scopus, and Web of Science without restriction of date. We searched provincial and federal websites, as well as the Proquest Dissertations and Theses Global database for grey literature.

Results: In total, 78 studies were included in the review. Of the 78 studies, 20 studies included elements of intersectionality through the intersections of individual-level characteristics. However, no studies used an intersectionality framework to guide their research on factors that affect vaccine uptake. Of the 19 studies that mention “gender”, 18 had misused this term, conflating it with sex.

Conclusion: Based on our findings, there is evident lack of intersectionality framework utilization in vaccine coverage research as well as misinterpretation of the terms “gender” and “sex”. Rather than focusing on discrete characteristics, health research should explore the interaction between numerous characteristics to better understand the barriers to immunization uptake in Canada.

Ian Simons & Jenny Lam

Ian Simons & Jenny LamStudy: Feasibility of Routine Quality of Life Assessments Using DEMQOL-CH in Alberta Assisted Living Facilities and Nursing Homes – A Mixed Methods Study, Dr. Matthias Hoben

Objective: Quality of life of nursing home and assisted living residents with dementia is currently not routinely assessed in Alberta. We aimed to determine the feasibility of routine quality of life assessments using the DEMQOL-CH, and assessed internal consistency reliability, test-retest reliability, inter-rater reliability, and response process validity of the DEMQOL-CH.

Design: Mixed methods study including structured quality of life assessments using DEMQOL-CH, and semi-structured cognitive interviews.

Setting and participants: We purposively recruited 6 nursing homes and 5 assisted living facilities in Alberta. From these facilities, 67 care aides were recruited to report on the quality of life of 240 selected residents. 6 care aides were purposively recruited for cognitive interviews.

Methods: The DEMQOL-CH is a 31-item questionnaire administered to care staff for proxy health-related QoL assessments. Alongside Dr. Hoben’s team, we interviewed care staff using the DEMQOL-CH via video calls. We used this data to assess missing data, item-level means and medians, internal consistency reliability, inter-rater reliability, and test-retest reliability using SAS 9.4; and response process validity with cognitive interviews and probing.

Results: No missing data was found for DEMQOL-CH items. Internal consistency reliability (0.818, 95% CI: 0.757; 0.854) was satisfactory and test-retest reliability for all strata was acceptable. Inter-rater reliability (0.318, 0.128-0.495) was low. Response process validity was acceptable for 28 items.

Conclusion: This study provides additional evidence regarding the feasibility of routine quality of life assessments using DEMQOL-CH in facilities in Alberta. Routine assessments will inform interventions to improve residents’ quality of life.

Laura Streith & Jordan Overwater

Jordan Overwater and Laura StreithStudy: Adjusting to and coping with dialysis: a cross-sectional survey of Albertans on dialysis, Dr. Kara Schick-Makaroff

Background: In Canada, 1 in 10 people suffer from kidney disease. For patients with kidney failure, dialysis is the only treatment, besides a kidney transplant, to keep them alive. Kidney disease and dialysis can take a significant psychological toll, and dialysis patients are more likely to suffer from mental health conditions than the general population. Currently, the mental health needs of dialysis patients in Alberta are unaddressed.

Objective: To describe preferences for mental health support reported by Albertan dialysis patients.

Methods: All adult Albertan dialysis patients (N = 2972) were mailed an invitation on January 8th, 2021 to complete a survey, which included demographics, preferences for mental health support, and validated quality of life assessment tools (Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7], and Kidney Disease Quality of Life Instrument-36 [KDQOL-36]). Survey components were analyzed through descriptive statistics.

Results: A total of 384 patients responded; 312 shared their dialysis modality and completed a valid PHQ-9; their answers were used for analyses. Most participants (59.6%) would consider engaging in support for coping with dialysis. Participants were most willing to try a medication discussion about their mental health concerns with a primary care doctor (72.1%) or nephrologist (62.9%), peer support groups (64.9%), and talk therapy (60.0%).

Conclusion: Findings from this project will inform future practice related to mental health support for dialysis patients, and the development of a future clinical pathway to guide kidney care providers in Alberta.

Brooklyn Grainger

Brooklyn GraingerStudy: Post-Death Burial and Funeral Practices in Rural Alberta: A Scoping Review

Background: Post-death burial and funeral practices are important events that allow families and communities to grieve and remember the deceased. Rural people’s post-death practices may be influenced by their distinct cultural norms; however, there is little published literature about what post-death rituals rural people choose. Purpose: The purpose of this project is to discover what information exists on the current post-death burial and funeral practices for residents of rural Alberta, a western Canadian province with a large rural population.

Methods: This scoping review examined research and non-research material. A traditional literature search was conducted in CINAHL, Medline, and PsycInfo in February of 2021. All articles included had to report on practices from rural areas in Canada or other developed countries, be peer-reviewed, and be written in English. The second search examined select rural Albertan community print information, including obituaries and funeral home websites. Data extraction occurred for all information sources, and a thematic analysis of findings was conducted.

Results: The traditional academic literature search yielded 173 potential results. Following title and abstract screening by one reviewer, one article was identified as potentially relevant and was retained for analysis following a full-text review. Moreover, information was collected from 1,760 obituaries and from 11 funeral home websites in rural Alberta. Among these, 77% of individuals whose interment method was stated in their obituary were cremated. Additionally, according to obituary information, 41% of mortuary ceremonies were held in a church, and 48.4% of ceremonies occurred in non-religious settings. Funeral planning and personalization, maintaining a connection to the rural land, maintaining family connections, involving family in post-death rituals, and having their standing in the community recognized were identified as important to rural people.

Conclusion: Funeral and interment practices are evolving in rural areas. This project begins to address a knowledge gap; however, further research is needed to learn more about the significance of rural people’s post-death practices.

Emily Checkwitch & Lydia Antwi

Lydia Antwi & Emily CheckwitchStudy: Association between Sex and Mental Health Sequelae after ICU Discharge: A Scoping Review

Supervisor: Dr. Elisavet Papathanassoglou

Background: Following discharge from intensive care units (ICUs), more than 50% of patients may develop mental health conditions including depression, post-traumatic stress disorder (PTSD), and anxiety. However, there is limited research to suggest risk factors and new possibilities for management.

Objective: Are there sex-related differences in the incidence, severity, and duration of mental health sequelae in adults after ICU discharge?

Methods: We conducted a scoping review which included studies published in English within the last 20 years, focusing on sex and mental health sequelae post-ICU. Online databases MedLine, EmBASE, Scopus, PsycINFO, and CINAHL were explored as of September 22, 2021.

Results: Of the 706 studies screened, six were included, and three demonstrated a statistically significant association between sex and mental health sequelae. Three outcomes of interest were noted: mental health-related quality of life (HRQoL), post-traumatic stress symptoms (PTSS), major depression/PTSD comorbidity, and major depression. Three studies that addressed mental HRQoL noted a decreased mental HRQoL in women compared to men, but two were statistically significant. No statistically significant association was found between sex and PTSS. One study examined both major depression/PTSD comorbidity and major depression and found a statistically significant association between female sex and both outcomes.

Conclusion: Despite methodological limitations of the identified studies, this scoping review shows a trend for worse mental health outcomes in females post-ICU. More research focusing on confounding factors is needed to better understand the associations between sex, gender, and mental health sequelae in post-ICU patients.

Cassidy Dukes

Cassidy DukesStudy: Research Overview: Improving Student Nurses’ Perspectives Towards Older People With an e-Learning Activity: A Quasi-Experimental Pre-Post Design

Supervisor: Dr. Sherry Dahlke

Nurses make up a substantial portion of the healthcare workforce. The age group they will most often interact with is older adults. Most unfortunately, institutional ageism exists in many of the facilities access by older adults. Nurses are not immune to these beliefs, which are born from a lack of sufficient gerontology content in curricula, and negative socialization in the clinical setting.

The aim of this study was to determine if some of these ageist beliefs could be addressed in nursing education using a virtual e-Learning activity. The final sample consisted of 207 second-year nursing students in a four-year collaborative baccalaureate program and first-year nursing students in a two-year after degree program. A virtual e-Learning activity was developed and positioned between two surveys. We selected a quasi-experimental pre-post design to measure students’ survey answers before and after the virtual e-learning activity. We noted a statistically significant decrease in students’ ageist beliefs after completing the activity. The strength of these results highlights the importance of engaging and flexible gerontological education and serves as a springboard for future research on this topic.