Putting On and Taking Off the Capulana: A Grounded Theory of How Mozambican Women Manage Gender Oppression.

Gender-based oppression is a pervasive global challenge, but has taken a back seat to other issues in Mozambique. The purpose of this grounded theory study was to explore how Mozambican women manage multiple oppressions in their lives in the context of the AIDS epidemic. Using interviews, documents, and constant comparison, we constructed a theory, to explain how women are socialized into and push back against the prevailing societal misogyny.

Risking vulnerability: Enacting moral agency in the is/ought gap in mental health care.

Aim: To explore how healthcare providers in acute care mental health settings navigate ethically challenging situations, enact moral agency, practice in congruence with ethical standards and mitigate moral distress (MD).

Design: Grounded theory, a qualitative methodology.

Methods: Over 18 months between 2015 and 2017, we reviewed documents, conducted observations and interviewed multidisciplinary participants (N = 27) from inpatient and emergency departments.

Teaching nurses teamwork: Integrative review of competency-based team training in nursing education.

Widespread demands for high reliability healthcare teamwork have given rise to many educational initiatives aimed at building team competence. Most effort has focused on interprofessional team training however; Registered Nursing teams comprise the largest human resource delivering direct patient care in hospitals. Nurses also influence many other health team outcomes, yet little is known about the team training curricula they receive, and furthermore what specific factors help translate teamwork competency to nursing practice.

Nurse practitioners changing health behaviours: one patient at a time.

In 2005, legislation was enacted allowing nurse practitioners (NPs) to practise in British Columbia, Canada. Although substantial human and financial resources had been dedicated to the implementation of the role, no evaluation has been conducted to date. As part of a larger multiphase, mixed-methods study design, which evaluated the integration of NPs into the British Columbia healthcare system, this article describes findings related to changes that result for patients and the implications for the healthcare system when NPs become part of the care process.

Nurse Practitioner Perceptions of the Impact of Electronic Medical Records Upon Clinical Practice.

A survey was conducted in the province of British Columba, Canada with nurse practitioners (NP). This paper reports on the quantitative and qualitative findings of the survey questions specifically focused on NP perceptions of the clinical impacts associated with using electronic medical records (EMRs) in a primary care setting. Findings suggest that although NPs perceived EMRs to improve the overall quality of clinical decisions, challenges remain in terms of tailoring the design of EMRs to address NP needs.

Using a mixed-methods design to examine nurse practitioner integration in British Columbia.

Aim: To discuss and provide examples of how mixed-methods research was used to evaluate the integration of nurse practitioners (NPs) into a Canadian province.

Background: Legislation enabling NPs to practise in British Columbia (BC) was enacted in 2005. This research evaluated the integration of NPs and their effect on the BC healthcare system.

Discovering health knowledge in the BC nurse practitioners encounter codes.

Integrating the Nurse Practitioner (NP) role into clinical practice settings is new in British Columbia (BC), Canada. Encounter codes are unique numeric codes assigned to specific types of patient care services performed by NPs. In this study we apply knowledge discovery techniques to analyze the encounter codes extracted from the BC Ministry of Health database to understand the most common practice activities carried out by NPs and what diseases patients sought care for from NPs.

How are electronic medical records used by nurse practitioners?

In this paper we describe how nurse practitioners (NPs) use electronic medical records (EMR) features and functions at: (1) an individual and (2) a clinic level to support patient wellness and chronic disease management activities. Fifteen NPs from British Columbia (BC), Canada participated in a qualitative, semi-structured interview study. NPs used EMRs with individual patients and at a clinic level to support wellness and chronic disease management activities.

Electronic Record Adoption and Use among Nurse Practitioners in British Columbia.

There has been a research focus on physician adoption of electronic medical records (EMRs). However, there has been less research into nurse practitioner (NP) use of EMRs. The authors present findings on the adoption and use of EMRs by NPs arising from a survey of the patterns of NP practices in the Canadian province of British Columbia.

Public health reform and health promotion in Canada.

More than 25 years have passed since the release of the Ottawa Charter for Health Promotion. This document represented a substantial contribution to public health in its emphasis on the economic, legal, political and cultural factors that influence health. With public health renewal underway across Canada, and despite overwhelming support in the public health community for the Ottawa Charter, how much its principles will be included in the renewal process remains unclear.

Articulating new outcomes of nurse practitioner practice.

Purpose: The purpose of this article is to describe how two mid-range theories, Kolkaba's Comfort Theory and Antonovsky's Sense of Coherence can be used to illuminate the holistic nature of nurse practitioner (NP) practice.

Data Sources: Original research and theoretical papers related to both theories described.

Conclusions: The NP role has been in existence for more than 40 years and can be found in healthcare systems in more than 60 countries around the world.

Fading vision: knowledge translation in the implementation of a public health policy intervention.

Background: In response to several high profile public health crises, public health renewal is underway in Canada. In the province of British Columbia, the Ministry of Health initiated a collaborative evidence-informed process involving a steering committee of representatives from the six health authorities. A Core Functions (CF) Framework was developed, identifying 21 core public health programs.

Use of knowledge discovery techniques to understand nurse practitioner practice patterns and their integration into a healthcare system.

The objective of this study is to assess the feasibility of applying knowledge discovery techniques to identifying nurse practitioner practice patterns and enacted scope of practice. For the research, we plan to use data extracted from a Ministry of Health database. The data items are focused around: nurse practitioner demographics, health authorities, and encounter types.

Doing the best I can do: moral distress in adolescent mental health nursing.

The purpose of this research was to explore the process used by mental health nurses working with adolescents to ameliorate the experience of moral distress. Using grounded theory methodology, a substantive theory was developed to explain the process. All the incidents that led to the experience of moral distress were related to safety and resulted in the nurses asking themselves the question, "Is this the best I can do?" Engaging in dialogue was the primary means nurses used to work through the experience of moral distress.

Longing for ground in a ground(less) world: a qualitative inquiry of existential suffering.

Background: Existential and spiritual concerns are fundamental issues in palliative care and patients frequently articulate these concerns. The purpose of this study was to understand the process of engaging with existential suffering at the end of life.

Methods: A grounded theory approach was used to explore processes in the context of situated interaction and to explore the process of existential suffering.

Existential suffering in the palliative care setting: an integrated literature review.

Context: Existential and spiritual concerns in relation to palliative end-of-life care have received increasing attention over the past decade.

Objectives: To review the literature specifically related to existential suffering in palliative care in terms of the significance of existential suffering in end-of-life care, definitions, conceptual frameworks, and interventions.

Methods: A systematic approach was undertaken with the aim of identifying emerging themes in the literature.

Keeping vigil over the profession: a grounded theory of the context of nurse anaesthesia practice.

Background: Nurse anaesthetists in the US have faced continued, repeated challenges to their profession. Regardless, they have met these challenges and have established themselves as major anaesthesia care providers. In this paper we address the research question: How do certified registered nurse anaesthetists (CRNAs) manage the socio-political context in which they provide care for their patients?

Methods: Grounded theory was used to explore how nurse anaesthetists protect and promote their profession.

Keeping Vigil over the Patient: a grounded theory of nurse anaesthesia practice.

Aim: This paper is a report of a study exploring the role and practice of nurse anaesthetists, with particular attention to describing how it is 'nursing'.

Background: In many countries, there is no nurse anaesthetist role. Recent events suggest that hesitancy about the role may be changing in Canada.

A closer look at the "supervision" and "direction" of certified registered nurse anesthetists.

A growing shortage of anesthesiologists in Canada has prompted discussion of how anesthesia provision can be expanded. Canadian anesthesiologists generally support a team approach in which physicians supervise alternative providers. In the U.

The tyranny of consensus: implications for nursing education.

The egalitarian appeal of decision making based on consensus has been valued as a strong alternative to other decision making approaches such as voting. In this paper, we identify some of the challenges inherent in this view, and suggest consideration of alternative decision making approaches needed at times to help nurse educators in their work with students and colleagues. As nurse educators, we have a responsibility to educate students about the meanings of consensus, to encourage open discussion about implicit values underlying behaviors, and help them appreciate the importance of dissent in a democratic society.

Knowledge translation to advance the nurse practitioner role in British Columbia: researchers and decision-makers conduct policy-relevant research to guide legislative and regulatory development and the design of a nurse practitioner education program.

This project brought together a team of researchers and decision-makers to conduct policy-relevant research to support the introduction of advanced nursing practice roles in British Columbia. All team members, including decision-makers, were actively involved in the conceptualization, design, data collection, analysis and interpretation of the study. This level of engagement, coupled with ongoing knowledge translation (KT) activities, led to the implementation by stakeholders of a majority of the study's recommendations.

Dancing to our own tune: understandings of advanced nursing practice in British Columbia.

There has been ongoing confusion about the meaning of advanced nursing practice (ANP) and the nature of ANP roles in Canada and elsewhere. A broad range of roles and titles have been adopted throughout Canada in an attempt to delineate specialized and/or advanced roles within nursing. One key objective in a recent three-phase study of ANP in British Columbia was to clarify the role and understanding of advanced nursing practice and related roles within the larger healthcare system.

Keeping it together: how women use the biomedical explanatory model to manage the stigma of depression.

Although considerable research has been conducted on women who are depressed, the actual experiences and voices of women have not been central to this research. Therefore little is known about how women make sense of depression as they live with and manage it in their daily lives. Our purposes in doing this study were to (1) examine how women experience and manage depression and treatment, and (2) investigate the core components of women's explanatory models of depression (including beliefs about etiology, onset of symptoms, pathophysiology, course of illness, and treatment needs).