Cette étude examine les perceptions du personnel enseignant francophone d’éducation physique et santé (EPS) au primaire en Ontario à l’égard de la nature, des fonctions et des modalités de développement de la pensée critique (PC) chez les élèves. Bien que la PC soit reconnue comme une compétence transversale essentielle dans le programme-cadre d’EPS, lequel privilégie une conception holistique de l’apprentissage dépassant la seule performance motrice, les connaissances empiriques demeurent limitées quant à la manière dont les enseignant.e.s d’EPS en contexte francophone minoritaire conçoivent et soutiennent cette compétence. S’inscrivant dans le paradigme de la pensée des enseignants (Clark et Peterson, 1986), cette recherche qualitative, exploratoire et descriptive mobilise un questionnaire électronique ainsi que des entrevues individuelles menées auprès de vingt-six enseignant.e.s francophones d’EPS. L’analyse révèle une conceptualisation partielle de la PC, une compréhension approfondie de son rôle dans l’apprentissage et le développement global des élèves, ainsi qu’une connaissance de stratégies pédagogiques actives et centrées sur l’élève visant à en favoriser l’émergence. Les résultats mettent en évidence la nécessité d’approfondir l’étude sur les pratiques effectives des enseignant.e.s en EPS afin de mieux cerner les conditions propices à une intégration authentique de la PC dans l’enseignement.
This study addressed the impact of the Coronavirus-19 (COVID-19) pandemic on the mental health of registered nurses (RNs) and registered practical nurses (RPNs) in Northern Ontario. The research question guiding this study was: What are the perceived mental health impacts of COVID-19 on Northern Ontario registered nurses and registered practical nurses working during the pandemic? This study used an inductive qualitative research design and the Nursing Worklife Model as the theoretical framework. A total of 127 nurses provided qualitative comments. The key overarching theme was Surviving the Chaos of COVID-19 and was supported by four themes and two subthemes: 1) threats to nurses’ health and well-being with two sub-themes: 1.1) threats to nurses’ mental and 1.2) emotional health and b) threats to nurses’ safety); 2) cut off from the familiar, 3) systemic chaos, and 4) navigating diminished supports and resources. The findings suggested that threats to nurses’ mental health and well-being during COVID-19 were multifaceted, leading them to perceive surviving the overall chaos of the pandemic. The insights gained from this research can serve as a basis for policymakers to ensure that nurses have the necessary resources and supports to prevent compromises to patients and nurses’ psychological, and physical health outcomes.
Background: In rural and small town communities in Canada, limited health infrastructure and geographic isolation intersect with cisnormative and cissexist systems of care to intensify health inequities for transgender and gender diverse (TGD) people and communities. This community-based needs assessment study examines the health and health care experiences of TGD residents in North Simcoe and Muskoka, a predominantly rural region of Central Ontario. Aim: Guided by a social determinants of health framework, the project was collaboratively designed with a TGD community reference committee and partner organizations to assess self-reported health status, service access, and structural barriers to care. Methods: Fifty-eight TGD residents completed an online survey, and focus groups were conducted across four communities to deepen understanding of lived experiences. Quantitative findings revealed significant associations between income, education, mental health, and suicidality. Qualitative findings illuminated the compounded effects of rurality, cisnormativity and cissexism, and limited local infrastructure, including experiences of provider incompetence, refusal of care, care avoidance, and identity negation. Participants described fragmented mental health services that separated gender-affirming care from broader psychological support, which exacerbated distress. At the same time, peer networks emerged as a significant protective factor, facilitating resource sharing, safety navigation, and emotional support. This study illustrates how rural TGD health inequities are structurally produced and offers evidence to inform locally grounded, gender-affirming service development. Findings directly contributed to the establishment of a regional TGD health clinic with a mandate for education, training, and peer support integration.
As the popularity of International Service-Learning (ISL) excursions continues to grow, there is an increasing need for research that explores these types of experiences. This manuscript focuses on the experiences of the lead author (S.L.D.) while participating in an ISL excursion offered by the Health Promotion Without Borders (HPWB) Program as part of their graduate research. The HPWB Program has facilitated ISL excursions for students in the School of Kinesiology and Health Sciences (SKHS) at Laurentian University (LU) in Canada for over two decades. However, there is limited formal research about the experiences of HPWB participants while completing their ISL excursions. This research addresses this need by using an autoethnographic approach to explore the lead author's HPWB experience. During the lead author's excursion, they confronted many moments of cultural dissonance, which challenged their usual way of thinking. Through critical reflection after their excursion, the lead author realized the defining role those moments of cultural dissonance had on the nature of their ISL experience. The lead author wrote six stories to share their understanding of those cultural dissonance encounters and provide a snapshot of their excursion for the reader to make sense of in their own way. Overall, this research may benefit future ISL participants and coordinators and adds to the sparse literature available on the nature of ISL experiences from the participant perspective using an autoethnographic method.
Les infirmiers prennent du recul face à leur mission de soigner les clients agressifs atteints de trouble de personnalité limite (TPL) et par conséquent, la qualité des soins s’avère détériorée. Cette revue systématique de la littérature a déterminé les interventions pour soigner cette population : favoriser l’autonomie du client en l’intégrant dans le processus des soins ; consolider une relation thérapeutique ; explorer son intérêt, son expérience et la pathologie de TPL pour comprendre le sens des actes du client, suivre des cours spécialisés, prendre soin de soi ; trouver du soutien auprès des collègues ; éviter les préjugés et la stigmatisation, intégrer les valeurs, croyances et culture dans les interventions infirmières, recourir à la thérapie comportementale dialectique et à la thérapie du schéma cognitive.
La présente étude phénoménologique vise à décrire l’expérience des personnes aînées francophones qui logent en centres d’hébergement des régions du centre et du sud-ouest de l’Ontario autant que celle des personnes aidantes qui accompagnent ces personnes aînées francophones. Quatorze personnes (n=14) aînées ont été rencontrées et interrogées à l’aide d’une entrevue individuelle dans des centres d’hébergement francophones, ou anglophones, ainsi que dix-neuf (n=19) personnes aidantes. Les résultats de cette analyse phénoménologique montrent une insatisfaction générale, devant le relogement dans un milieu non adapté aux besoins de la personne aînée francophone. La compréhension de la langue anglaise représenterait un vecteur de marginalisation dans ces centres d’hébergement. Les thèmes qui ont été dégagés se rapportant aux personnes aînées francophones soulignaient : la présence de barrières linguistiques, une forme d’inadaptation culturelle et sociale, une marginalisation et une difficulté d’intégration dans ces centres de la part de résidents. Quant aux personnes aidantes, la construction de centres francophones a été présentée comme une solution au problème d’hébergement des personnes aînées dont le français est la langue première ou habituellement d’usage. En conclusion, il faut que les services de santé et les soins offerts à cette population soient donnés en français afin d’augmenter les relations positives à l’entourage et la confiance envers le réseau de santé de l’Ontario.
Résumé Le vieillissement de la population canadienne appelle à une évolution du système de santé en raison des multiples enjeux qu’il soulève. En 2008, l’Institut national de santé publique du Québec adopte une nouvelle approche visant la prise en charge du vieillissement dans une perspective de responsabilité populationnelle. Cet article analyse l’espace d’innovation ouvert dans la mise en œuvre par les primo adoptants de cette approche. Cette analyse permet de suggérer que le compromis social est un incontournable à la fois pour la réussite de cette innovation et, in fine, au vieillissement en santé. De plus, l’innovation ne suffit pas à atteindre cet objectif ultime. Sa mise en œuvre requiert de laisser aux acteurs la latitude de sélectionner, à partir d’une démarche d’élaboration de compromis sociaux, les solutions conformes à une éthique du bien-être collectif adaptées aux conditions locales de mise en œuvre de l’approche.
Sudden cardiac arrest, abrupt cardiovascular collapse with loss of vital signs, is a leading cause of death. The uptake of emerging evidence, however, optimizes survival rates. For those who survive, and their family members, life can involve enduring physical, mental, cognitive, and social alterations which warrant evidence-informed interventions by health and social service providers. The study purpose was to aggregate published qualitative evidence to yield an understanding of survivors' and family members' life experiences following hospital discharge after a cardiac arrest. The study design, metasummary, was suitable for describing survivors’ and their family members’ experiences following the paradigm life-altering cardiac event. Nineteen primary studies, with a population of 288 adults, met the inclusion criteria. Extraction, abstraction, and aggregation of findings yielded eight topical categories labelled: acknowledging life has changed; confronting mortality; regaining former life; interacting within the family, interacting within the broader social context; involving healthcare providers; evolving health status; and enacting a new life. These topical categories combine to represent two overarching themes - seeking wholeness and being connected. Survivorship relies on pragmatic support from and connection with family, friends, peers, and healthcare providers to address the complexity of challenges following cardiac arrest. Amid these challenges, the early development of individualized recovery plans have the potential to promote continuous and comprehensive care for survivors and families. Further, strengthening interprofessional service planning and delivery, integrating innovative technologies, and tailoring comprehensive care based on individual needs of both survivors and their family has the potential to address wellbeing following cardiac arrest.
Introduction: The Remote First Aid Self-Efficacy Scale was originally developed as a 30-item self-report instrument designed as an evaluation tool for training providers and a reflection tool for course participants. Remote first aid training courses and programs are designed for remote communities, worksites, and other wilderness contexts involving activities such as recreation, education, and therapy. Self-efficacy refers to the strength of the beliefs a person has in their capacity to organize and take the necessary actions towards any given attainment. The purpose of our study was to measure the reliability and validity of the 15-Item Remote First Aid Self-Efficacy Scale (RFA SES) in French and English populations. Methods: Alumni from SIRIUSMEDx wilderness first aid courses were invited via email to complete either a French or English online questionnaire at two different time periods (T1 & T2). Data collection involved using online questionnaires containing demographic questions, the 15-Item RFA SES, and the 10-Item Generalized Self-Efficacy Scale (GSES). Data analysis involved assessing the scale for internal consistency, test re-test reliability, and concurrent validity. Results: There were 58 French and 47 English alumni respondents from SIRIUSMEDx courses for a total of 105 respondents. Internal consistency was high amongst the French group (alpha = .95) and the English group (alpha = .92). Test re-test reliability was high amongst the French group, (r = 0.78, p < .01), and the English group (r = .92, p < .01). The correlations between the RFS SES and GSES were positive and moderate in the French group (r = 0.53, p < .01), as well as in the English group (r = 0.32, p = .03). Conclusions: Results from this study suggest that both the French and English 15-Item RFA SES are reliable and valid. This shorter 15-item version is now available for use, along with the original validated 30-Item version of the RFA SES. Future research should focus on validation of the scale in other contexts and populations, using the scale as a participant reflection tool, and using it for evaluation of training programs and courses.
En 2015, l’examen canadien d’admission à la profession infirmière a changé de format et est devenu similaire à celui des États-Unis. Les premiers résultats canadiens à l’examen d’admission NCLEX-RN ont démontré de nombreux échecs, qui touchaient davantage les francophones. Le but de la recherche était de décrire l’expérience de cet échec par des diplômées d’un baccalauréat en sciences infirmières francophone. Un devis qualitatif de type phénoménologique a été retenu comportant des entrevues individuelles semi-dirigées. La méthode d’analyse de Giorgi a été effectuée. Les résultats ont démontré que les participantes francophones ont vécu des difficultés supplémentaires peu importe la langue choisie qui, entre autres, a résulté à un ou plusieurs échecs de cet examen. L’impact d’un échec est dévastateur pour ces candidates et a des répercussions négatives sur les programmes de sciences infirmières francophones ainsi que sur l’accès au service de santé en français.
Purpose: Accessible primary health care (PHC) is a key area of interest for policy and research as accessible PHC is associated with better health outcomes and lower health system costs. A critical dimension of accessible PHC is an adequate supply of family physicians (FPs) or general practitioners (GPs). Our study sought to analyze the geographic distribution of FP/GPs practicing in Nova Scotia (NS) and to provide an in-depth analysis of the distribution of FP/GPs in relation to population PHC needs. Methods: Using data from the College of Physicians & Surgeons of Nova Scotia’s registry and 2019 annual license renewal survey, we provide a descriptive analysis of physician distribution, demographics and practice structure characteristics across the four Nova Scotia Health management zones (Central, Eastern, Northern, Western) for the population of FP/GPs practicing in NS in 2019. Additionally, we provided a descriptive analysis of PHC demand indicators and population demographics derived from the Canadian Institute for Health Information, the Canadian Community Health Survey, and the Canadian Census. These population PHC need indicators include hospitalization rates for ambulatory care sensitive conditions (ACSC), perceived health, the Canadian Index of Multiple Deprivation (CIMD), and the percentage of the population aged 65 and over across Nova Scotia Health management zones. Results: FP/GPs practising outside the Central zone are less numerous, older, and more likely to be male and international medical graduates. FP/GPs practicing outside the Central zone are more likely to have solo practices, practice in rural areas and not provide care through technology. Additionally, there is a greater potential demand for PHC outside of the Central zone, indicated by lower physician-to-100,000 population ratios, higher rates of hospitalizations for ACSC, a larger percentage of individuals living in rural areas, aged 65 and over, rating their health as fair or poor, and in the most deprived quintile of the situational vulnerability and economic dependency dimensions of the CIMD. Conclusions: These findings indicate a geographic maldistribution of physicians across NS and potential gaps in access to FP/GPs compared to population health needs across Nova Scotia Health management zones. The findings have implications for targeted physician resources planning and policy.
Objectives: Substance use, both alcohol and opioids, is higher in Sudbury, Ontario than in the remainder of the province and the numbers increased during COVID-19. In response to increased use during the pandemic, the hospital developed the Addictions Medicine Consult Service (AMCS) to complement the existing addiction services. After a full year of operation, a program evaluation was completed to determine the effectiveness and gaps of the AMCS, to enact changes for service improvement. Methods: A retrospective chart review was conducted. Analysis of the characteristics and frequency of people presenting with substance use to the emergency department, along with referrals to addiction services, was undertaken. Results: Fewer than seven percent of patients presenting with substance use in the emergency department were referred to the AMCS. The majority used alcohol and were housed, followed by those who used fentanyl who were unlikely to be housed. Many patients were referred to Crisis, the multidisciplinary mental health team in the hospital, which is available 24/7 but which does not include addictions expertise. Conclusions: Changes to service delivery to increase the use of the AMCS were implemented to improve service accessibility and delivery of care. These included nursing daily rounds in the emergency department and adding more direct links with resources in the community.
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, causing 3.23 million deaths in 2019. Cigarettes are the leading cause of this disease. However, workplace exposures, including those in the mining industry, may also lead to COPD. These exposures include dust and fumes that can be higher for mineral industry workers who work in confined areas. As a result, workers in the minerals industry may submit compensation claims. Sadly, work-related COPD is not well compensated or recognized by the Ontario Workplace Safety and Insurance Board (WSIB). Physicians and union representatives struggle to complete forms and have claims approved, and because of this, workers can struggle with money, family, and mental health problems. This qualitative narrative study used in-depth telephone interviews (eight) to collect information. The information collected from physicians (four) and union representatives (four) was analyzed to understand their perspectives and experiences when assisting workers with compensation claims. This is the first study to examine how COPD could affect underground mineral workers in Northeastern Ontario. Themes identified in this study include 1) additional administrative and human support resources are required, 2) smoking cessation is essential, 3) COPD is a crippling disease, 4) education is required to support documenting an occupational illness, 5) the compensation claim process is challenging; 6) occupational diseases are challenging to prove, 7) occupational COPD is costly. This study may help with compensation services and provide support for physicians and union representatives involved with an underground mineral worker diagnosed with occupational COPD.
Introduction: International service-learning (ISL) excursions involve service work with international communities, coupled with academic learning and reflection for the students involved. There are anecdotal descriptions that this can result in cultural dissonance as part of the learning and service provision process. The Health Promotion Without Borders (HPWB) program at Laurentian University in northern Ontario, Canada, provides undergraduate students with an opportunity to engage in ISL. However, no formal research has investigated HPWB participants' experiences of cultural dissonance. Thus, we used the HPWB excursion in 2017 to answer the research question: "To what extent was cultural dissonance experienced by HPWB participants during their excursion to Mongolia?" Approach: We used a case study approach to investigate HPWB program participants' experiences of cultural dissonance during an ISL excursion to Mongolia from May 21st – June 19th, 2017. During the excursion, participants were engaged in teaching health promotion lessons to women and children in the local communities. The students were required to keep daily journals of their experiences as part of the ISL component. Those journals were then made available for research under informed consent. The lead author then analyzed the transcribed excursion journals and identified and categorized examples of cultural dissonance within the HPWB participants' journals. These categories were reviewed and endorsed by the co-authors. Findings: We identified three categories related to the nature of cultural dissonance that were common for the HPWB participants: (1) Disruption to Personal Values, Routines, and Behaviours; (2) Application of Knowledge and Scope Limitations; and (3) The Role of Existing Relationships and Group Dynamics. Conclusion: Experiences of cultural dissonance were a central characteristic of the ISL excursion to Mongolia. This result extends the emerging literature on cultural dissonance in other ISL contexts. Future research should consider longitudinal and retrospective study designs to identify longer-term impacts and how these relate to the learning process. This could lead to developing an evidence-based theory on how cultural dissonance may enhance or diminish the educational process for ISL participants.
Annually, more than 30% of older adults experience a fall and most falls occur in the population aged 65 years and older. Research supports that factors leading to increased fall risk include the number of years institutionalized, performance of activities of daily living (ADLs), history of falls, age, diseases/conditions, cognitive impairment, sensory deficits, medication use, aggressive behaviours and environment. These factors destabilize older adults in long-term care (LTC) facilities and lead to falls. The term homeostasis is not present in nursing literature in relation to falls. The aim of this concept analysis was to operationalize the concept of homeostasis in relation to falls and examine how changes to this state can increase fall risk for older adults. Case scenarios and a concept map were used to illustrate the relationship between homeostasis and the risk of falling, in relation to falls in older adults.
North American researchers report that women who undergo a hysterectomy for benign conditions are threatened by health disparities. Few studies have examined race and health in Ontario women who underwent a past hysterectomy. The purpose of this descriptive correlational study was to describe and compare health features of racialized and non-racialized women. Using the most appropriate Canada’s Community Health Survey (CCHS) dataset, this study’s sample consisted of all Ontario residing female respondents (n = 1,730) who self-reported having had a hysterectomy with no cancer history. Socio-demographic and health-related variables were extracted in accordance with the Gender and Equity Health Indicator Framework (Clark & Bierman, 2009). Chi-squares and z-scores were calculated to compare racialized and non-racialized women health indicators. Many of the significant differences were found within the non-medical determinants of health domain. Study implications reinforce the need for aggregated gender data by race in Ontario to address health equity.
Canada’s history of European colonization-imposed measures on the Indigenous peoples of Canada has created considerable discrepancies in this population’s health and wellness. Community leaders in Dokis First Nation and College Boreal researchers explored the use of wearable digital health technology during harvesting activities. Fitbit watches were worn by community members during traditional activities, introducing 2 null hypotheses: a) the canoe trip does not increase physical activity, b) the hide preparation activity does not increase physical activity. Each activity included 6 participants from Dokis First Nation and, based on the results, the canoe trip significantly increased their physical activity levels while the hide preparation did not increase their physical activity levels significantly. The study can also be used as an example of how Canadian Colleges and its researchers can be mobilized on behalf of First Nation leaders assisting their communities and its membership.
Real-world food label reading is examined in two laboratory tasks to evaluate the role of cognitive factors in peoples’ willingness and ability to follow therapeutic diets. Participants were asked to repeatedly make decisions about the safety of foods that did or did not contain specified allergen targets; each of 30 foods were presented 15 times in randomized and intermixed orders. At each presentation the safety judgement could be made with or without consulting the food ingredient label. The results imply limitations to reading accuracy, learning, and judgements about that learning. Most participants became less likely to read ingredient lists over time, suggesting that decisions to read is driven by cost-benefit. The findings suggest that despite the improvements to food label formats, people probably choose not to read them as often as they should and will miss seeing target ingredients when they do.
Undergraduate nursing programs are moving towards a service learning model in teaching nursing student cultural awareness. In this article, we discuss the nursing student experience in a university elective which immerses students in rural and remote Indigenous communities resulting in cultural consciousness. This service learning experience that students encountered promoted growth in nursing praxis, and fostered positive curriculum growth and community partnerships between the College and the Indigenous communities in which they visited. Students gained cultural consciousness and increased awareness, which is beneficial in their future nursing careers as they grow into better culturally competent care providers. Also discussed is the history and background of these Indigenous communities, The Truth and Reconciliation Commission (TRC) and the First Nations Principles of OCAP (ownership, control, access and possession). These topics are discussed in detail throughout the student experience as they respond to nurses’ professional standards, development of cultural competency and integrating calls to action in truth and reconciliation.
Communication is essential to providing quality primary care. Linguistic concordance between patients and physicians has been linked to improved health outcomes and greater patient satisfaction. Although Canadian Francophones often struggle to access linguistics concordant health services, the concept of the active offer of French Language Services (FLS) has emerged as a means of ensuring the availability of such services and improving the francophone patient experience. However, the impact of language concordance and the active offer of FLS on patient satisfaction among Ontario Francophones remain largely unknown. Patient satisfaction surveys were collected as part of a continuing education program targeted at family physicians in Northeastern Ontario. Participating physicians distributed patient surveys consisting of select patient satisfaction questions from the Physicians Achievement Review (PAR) and select questions from the Active Offer of French Language Services in Minority Context Measure. Valid surveys were received from 235 patients. Just under half of these (44%) identified as Francophones, 62.6% had a French-speaking family physician; however, only 17.2% reported regularly speaking in French with their family physician. As hypothesized, there was a consistent tendency for Francophones who experience stronger linguistic concordance with their family physician to report higher satisfaction scores. Francophones who regularly speak French with their family physicians were more satisfied ( = 4.63) than those who rarely/never speak French ( = 4.29, F(1; 83) = 4.852; p < 0.05). There was also a statistically significant interaction between the patients' language of preference and the service language. Francophones who prefer French and regularly speak it with their family physician (linguistic concordance; adj= 4.82) were significantly more satisfied than those who prefer French yet rarely/never speak it (linguistic discordance; adj= 4.06, F(1; 75) = 11.950; p < 0.001). Furthermore, a positive correlation between patient satisfaction and the active offer was observed in Francophones (r = 0.49, p<0.001). The present findings provide evidence of the impact of linguistically adapted health care services on the satisfaction of Ontario Francophones and suggest that patient satisfaction may be improved through the active offer of FLS. A larger and more diverse sample is required to confirm these findings.
