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Athabasca, Canada

Lamarche K.,Athabasca University
The Canadian nurse | Year: 2013

Although nurse practitioners are well placed to counsel patients about getting enough exercise, little abstract is known about their attitudes and practice in this area of health promotion. The authors used a self-administered Internet-based questionnaire to explore how Canadian NPs perceive their competence in prescribing physical activity and the importance they ascribe to doing so. Participants were asked to identify factors that most commonly prompt physical activity prescription. Overall, the respondents felt fairly competent in their ability to prescribe physical activity (mean score 4.49/6.0, SD = .90) and felt that this function was important (mean score 4.82/6.0, SD = .85). Competence in prescribing physical activity and a perception that this intervention is important were both positively correlated with frequency of prescribing. The most commonly reported barrier to prescribing physical activity was a lack of time. On average, respondents prescribed physical activity to 59 per cent of their patients. The patient factors that most commonly prompted physical activity prescription were overweight or obesity, type 2 diabetes, hypertension and cardiovascular health. The lack of specific education in preventive medicine (e.g., obesity prevention, physical activity, nutrition) reported by 63 per cent of respondents points to the need for a physical activity prescription curriculum within nursing education to equip future NPs to respond to the high prevalence of physical inactivity in Canadian society. Source

This paper explores the nature of voluntary sector 'spaces of care.' In particular, the paper is concerned with spaces of care that have been established in response to urban homelessness. These include service environments such as emergency shelters, drop-in centres, and soup kitchens. Renowned for being health affirming, these environments also function as important political spaces in the city. One site in particular, a low-barrier emergency shelter, is examined in detail. This site's political significance is traced to the way in which it partakes in boundary work by defining who is worthy of support, who is to count as a citizen and which lives matter. This interpretation has important implications for how we understand the relationship between the health of marginalized populations, voluntary welfare provision and the state. © 2010 Elsevier Ltd. Source

Perry B.,Athabasca University
Canadian oncology nursing journal = Revue canadienne de nursing oncologique | Year: 2011

Compassion fatigue (CF) is "debilitating weariness brought about by repetitive, empathic responses to the pain and suffering of others" (LaRowe, 2005, p. 21). The work performed by oncology nurses, and the experiences of the people they care for, place oncology nurses at high risk for CF (Pierce et al., 2007; Ferrell & Coyle, 2008). Thus oncology nurses were chosen as the study focus. This paper details a descriptive exploratory qualitative research study that investigated the experience of CF in Canadian clinical oncology registered nurses (RNs). A conceptual stress process model by Aneshensel, Pearlin, Mullan, Zarit, and Whitlatch (1995) that considers caregivers' stress in four domains provided the study framework (see Figure 1). Nineteen study participants were recruited through an advertisement in the Canadian Oncology Nursing Journal (CONJ). The advertisement directed potential participants to a university-based online website developed for this study. Participants completed a questionnaire and wrote a narrative describing an experience with CF and submitted these through the secure research website. Data were analyzed thematically. Five themes include: defining CF, causes of CF, factors that worsen CF, factors that lessen CF, and outcomes of CF. Participants had limited knowledge about CF, about lack of external support, and that insufficient time to provide high quality, care may precipitate CF. The gap between quality of care nurses wanted to provide and what they were able to do, compounded by coexisting physical and emotional stress, worsened CF. CF was lessened by colleague support, work-life balance, connecting with others, acknowledgement, and maturity and experience. Outcomes of CF included profound fatigue of mind and body, negative effects on personal relationships, and considering leaving the specialty. Recommendations that may enhance oncology nurse well-being are provided. Source

Archer N.,McMaster University | Cocosila M.,Athabasca University
Journal of Medical Internet Research | Year: 2011

Background: There is a major campaign involving large expenditures of public money to increase the adoption rate of electronic health record (EHR) systems in Canada. To maximize the chances of success in this effort, physician views on EHRs must be addressed, since user perceptions are key to successful implementation of technology innovations. Objective: We propose a theoretical model comprising behavioral factors either favoring or against EHR adoption and use in Canadian medical practices, from the physicians' point of view. EHR perceptions of physicians already using EHR systems are compared with those not using one, through the lens of this model. Methods: We conducted an online cross-sectional survey in both English and French among medical practitioners across Canada. Data were collected both from physicians using EHRs and those not using EHRs, and analyzed with structural equation modeling (SEM) techniques. Results: We collected 119 responses from EHR users and 100 from nonusers, resulting in 2 valid samples of 102 and 83 participants, respectively. The theoretical adoption model explained 55.8% of the variance in behavioral intention to continue using EHRs for physicians already using them, and 66.8% of the variance in nonuser intention to adopt such systems. Perception of ease of use was found to be the strongest motivator for EHR users (total effect .525), while perceptions of usefulness and of ease of use were the key determinants for nonusers (total effect .538 and .519, respectively) to adopt the system. Users see perceived overall risk associated with EHR adoption as a major obstacle (total effect -.371), while nonusers perceive risk only as a weak indirect demotivator. Of the 13 paths of the SEM model, 5 showed significant differences between the 2 samples (at the .05 level): general doubts about using the system (P = .02), the necessity for the system to be relevant for their job (P < .001), and the necessity for the system to be useful (P = .049) are more important for EHR nonusers than for users, while perceptions of overall obstacles to adoption (P = .03) and system ease of use (P = .042) count more for EHR users than for nonusers. Conclusions: Relatively few differences in perceptions about EHR system adoption and use exist between physicians already using such systems and those not yet using the systems. To maximize the chances of success for new EHR implementations from a behavioral point of view, general doubts about the rationale for such systems must be mitigated through improving design, stressing how EHRs are relevant to physician jobs, and providing substantiating evidence that EHRs are easier to use and more effective than nonusers might expect. Source

Temple N.J.,Athabasca University
European Journal of Public Health | Year: 2012

This article examines the impact of disease prevention on health-care spending. The relationship between these two variables is more complex than what, at first glance, appears to be the case. Health-care spending would be reduced if more effective means could be found to prevent health problems that are expensive to treat but are generally not fatal, such as dementia, infectious diseases and accidents. The major focus here is on interventions designed to persuade people to quit smoking. Savings on health-care spending in early years after people stop smoking are counter-balanced (often exceeded) by higher spending at a later time. In addition, when people stop smoking there is a significant negative impact on government finances from the double effect of lost tax revenues combined with increased spending on pension payments. Arguments in favour of policies designed to prevent fatal disease, such as by reducing the prevalence of smoking, should be based on improvements to population health rather than on misleading claims that this will reduce spending on health care. © 2011 The Author. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. Source

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