Realist review of community coalitions and outreach interventions to increase access to primary care for vulnerable populations: a realist review.

Background: There are meaningful gaps in equitable access to Primary Health Care (PHC), especially for vulnerable populations after widespread reforms in Western countries. The Innovative Models Promoting Access-to-Care Transformation (IMPACT) research program is a Canadian-Australian collaboration that aims to improve access to PHC for vulnerable populations. Relationships were developed with stakeholders in six regions across Canada and Australia where access-related needs could be identified.

Examining dual roles in long-term-care homes in rural Alberta: a qualitative study.

Introduction: In rural settings, many healthcare professionals experience intersections of professional and personal relationships, often known as dual roles. Dual roles are traditionally studied in terms of their potential for ethical conflicts or negative effects on care. In the existing scholarship, there is little discussion of dual roles in long-term care (LTC) settings, which present distinct conditions for care.

Association between continuity and access in primary care: a retrospective cohort study.

Background: Continuity of care is a tenet of primary care. Our objective was to explore the relation between a change in access to a primary care physician and continuity of care.

Methods: We conducted a retrospective cohort study among physicians in a primary care network in southwest Alberta who measured access consistently between 2009 and 2016.

Letters to the Editor.

This article contains Letters from the Readears.

Mitigating Moral Distress in Dementia Care: Implications for Leaders in the Residential Care Sector.

In 2012, the World Health Organization estimated that the number of people living with dementia worldwide was approximately 35.6 million; they projected a doubling of this number by 2030, and tripling by 2050. Although the majority of people living with a dementia live in the community, residential facility care by nursing providers is a common part of the dementia journey in most countries.

Development and validation of the Moral Distress in Dementia Care Survey instrument.

Aims: To report on the development and validation of the Moral Distress in Dementia Care Survey instrument.

Background: Despite growing awareness of moral distress among nurses, little is known about the moral distress experiences of nursing staff in dementia care settings. To address this gap, our research team developed a tool for measuring the frequency, severity and effects of moral distress in nursing staff working in dementia care.

Mitigating Moral Distress in Dementia Care: Implications for Leaders in the Residential Care Sector.

In 2012, the World Health Organization estimated that the number of people living with dementia worldwide was approximately 35.6 million; they projected a doubling of this number by 2030, and tripling by 2050. Although the majority of people living with a dementia live in the community, residential facility care by nursing providers is a common part of the dementia journey in most countries.

Caring in the wake of the rising tide: Moral distress in residential nursing care of people living with dementia.

Objective Moral distress is increasingly being recognized as a concern for health care professionals. The purpose of this study was to explore the nature and prevalence of moral distress among nursing staff who care for people living with dementia. Methods This study was focused on nursing staff caring for people with dementia in long-term care and assisted living sites.

Sources of moral distress for nursing staff providing care to residents with dementia.

The World Health Organization estimates the number of people living with dementia at approximately 35.6 million; they project a doubling of this number by 2030 and tripling by 2050. Although the majority of people living with a dementia live in the community, residential facility care by nursing care providers is a significant component of the dementia journey in most countries.

Dementia care in the context of primary care reform: an integrative review.

Objectives: The purpose of this review was to determine the influence of the growing body of evidence about the attributes of high-performing primary care systems on the literature related to the primary care of people living with dementia.

Methods: In this integrative review, we examined a broad range of published and grey literature (2000-2013) about the primary care of dementia, using a systematic approach set up in advance of the literature search. The review was guided by two questions: What are the evident models of primary care for dementia? How do the models line up with the other attributes of high-performing primary care?

Results: Three models were noted: carved-out, co-managed, and integrative-hub, all informed by different assumptions about the role of primary care in dementia.

Sources of information used by nurses to inform practice: An integrative review.

Background: We present an integrative review of the literature about sources of information nurses use to inform practice. The demand for access to more and better information has been fueled by the evidence-based healthcare movement. Although the expectations for evidence-based practice have never been higher, the demands on care environments have never been greater.

The road less traveled: nursing advocacy at the policy level.

A frequent observation made about nursing advocacy at the policy level is its absence-or at least its invisibility. Yet there is a persistent belief that nurses will participate in advocacy at the societal level in matters of health. Although gaps exist in our knowledge about how to advocate at the policy level, the authors suggest that a number of other factors contribute to the disconnect between what nurses are expected to do in terms of policy advocacy and what they actually do.

Self-care from the perspective of people living with diabetes.

This review presents findings from a critical integrative review of research into barriers to and facilitators of self-care from the perspective of people with diabetes. The review was motivated by a perceived need to understand self-care from the perspective of those living with this chronic disease and to explore the implications of this understanding for health-care policy in Canada. Journal manuscripts and dissertations exploring self-care from the perspective of adults with type I or type II diabetes and published in English between 1993 and 2003 were reviewed.

Access to health services by Canadians who are chronically ill.

Access to health care services in Canada has been identified as an urgent priority, and chronic disease has been suggested as the most pressing health concern facing Canadians. Access to services for Canadians living with chronic disease, however, has received little emphasis in the research literature or in health policy reform documents. A systematic review of research into factors impeding or facilitating access to formal health services for people in Canada living with chronic illness is presented.

Out of fertile muck: the evolving narrative of nursing.

The ongoing debate over the appropriateness of embracing multiple research traditions in nursing is discussed, and the impacts of that debate on the development of nursing knowledge and the nature and structure of the discipline are explored. It is asserted that this previously healthy debate has become stalled between extreme positions of unbounded pluralism and critical exclusivism. The author suggests that one possible solution may lie in connecting the elements of human living, human healing, and human wholeness in an evolving narrative that crosses paradigmatic and theoretic boundaries, and reflects the unique meanings revealed in nursing practice and scholarship.