Browsing by Author "Genoe, Rebecca"

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Open Access
Accessing Intimacy: The Experience of Younger Long-Term Care Residents
(Faculty of Graduate Studies and Research, University of Regina, 2019-05) Sawatsky, Meghann Leslie; Johner, Randy; Kikulwe, Daniel; Genoe, Rebecca
The sex and intimacy needs of persons with disabilities are increasingly highlighted in research, particularly during the last two decades. There is also research to examine the experience of staff within long term care related to the sex and intimacy needs or behaviours of long-term care residents. However, there is limited research examining the experience of sex and intimacy from the viewpoint of residents, particularly younger residents of long-term care. This qualitative research study uses a phenomenological approach to explore the experiences of persons with disabilities, under the age of 70, living in a long-term care facility, accessing a sexual and intimate life. Four participants were recruited using a purposive, criterion sample. Through the data analysis, a central theme of It’s About Belonging emerged along with four subordinate themes, which include; Being Different From Others, New Relationships and Connections, Being Left, and Staff Facilitated. The discussion includes suggestions for increased education related to sexuality and intimacy for long-term care staff, the need for increased social work support, and long-term care alternatives. Improvements to the current long-term care system, such as smaller community homes, increased investment in community care are some ways in which the isolations experienced after moving to long term care could be alleviated.
Open Access
Attachment Orientation, Affect Regulation, and Coping Styles in Young Adults with Persistent, Transient, or Absent History of Deliberate Self-Harm
(Faculty of Graduate Studies and Research, University of Regina, 2012-06) Gelinas, Bethany Lee; Wright, Kristi D.; Hart-Mitchell, Regan D.; Sharpe, Donald; Genoe, Rebecca
The prevalence of deliberate self-harm (DSH) is on the rise, making clinicians more likely than ever to encounter DSH in their clinical practice (Klonsky, 2007; Nock, 2009), and consequently making research that informs such clinical practice increasingly vital. Past research has neglected to adequately explore the differences between absent, persistent, and transient DSH histories and the factors related to increased DSH frequency. Attachment orientation, coping styles, and affect regulation have been implicated as important to adjustment and psychopathology; however, the role of these constructs in DSH and specifically whether they can be successfully applied to explain the differences between DSH histories has yet to be explored. The purposes of this study were fourfold: (1) investigate the relationship between attachment orientation and likelihood of persistent, transient, or absent DSH; (2) determine whether motivations for engaging in self-harm, coping styles and affect regulation differ according to the individuals’ type of self-harm history; (3) investigate which constructs (attachment orientation, coping styles, affect regulation, or motivations) were most predictive of a particular self-harm history; and (4) develop a better understanding of the offset of DSH behaviour and how individuals managed to cease this behaviour. A battery of questionnaires was administered via an online survey to 139 university students in order to gain a better understanding of the relationship between these constructs and DSH history and frequency. The relative importance and predictive utility of these constructs, the differences between DSH histories, and the information obtained on DSH cessation could contribute to more successful treatment and more efficacious prevention. Findings are discussed in terms of clinical and scientific implications.
Open Access
Crafting Leisure Activities During COVID-19 Physical Distancing
(2023-08-31) Kulczycki, Cory; Genoe, Rebecca
In the late winter and early spring of 2020 Canada experienced the COVID-19 pandemic where he Federal Government of Canada along with the provinces encouraged residents to socially distance and non-essential businesses to close. Canadian participants completed an online survey about their crafting and how crafting was impacted during COVID-19 restrictions. The participants explained how the restrictions provided opportunities and constraints during the first wave of the pandemic. Crating provided escape from stressors and worries often providing pleasure and social connections and even learning opportunities. As a leisure activity crafting contributed to their perceived well-being during the time of the research.
Open Access
Determinants of Leisure-Time Physical Activity Participation Among African Students Attending a Canadian University
(Faculty of Graduate Studies and Research, University of Regina, 2018-09) Dasylva, Oluwakayode Tosin; Genoe, Rebecca; Kulczycki, Cory; Rossow-Kimball, Brenda; Daschuk, James; Rehman, Laurene A.
A recent report that examined university students across 23 countries found that 4 out of 10 students were physically inactive (Pengpid et al., 2015). Physical inactivity has been linked to certain types of preventable diseases (Myers et al., 2004). This study is an examination of the perceived factors influencing leisure-time physical activity (LTPA) among African students attending the University of Regina (U of R) to understand their experiences with and perceptions of LTPA. The study further explored how LTPA contributes to students’ wellness. This research was guided by an interpretive inquiry approach because it examines in-depth the meanings and understanding people create of their personal experiences and perceptions (Gephart & Rynes, 2004). Seven students were recruited for the study and semi-structured interviews were conducted during data collection. The transcripts were analyzed by way of inductive analysis, the most common approach for qualitative studies (Thomas, 2006). The results of the study provided insights into African students’ perceived benefits of LTPA and constraints to participation. This thesis sets out suggestions for improving or maintaining LTPA participation among the students. Finally, it contributes to the body of knowledge on the perceived constraints to physical activity and LTPA participation among international students and provides suggestions for further research. Keywords: leisure-time physical activity, participation, motivation, constraints
Open Access
The Efficacy of Online Vinyasa Yoga and Taijifit™ on Physical Health Outcome Measures and Quality of Live of Adult Informal Caregivers
(Faculty of Graduate Studies and Research, University of Regina, 2018-03) Martin, Andi Céline; Candow, Darren; Bruno, Paul; Novik, Nuelle; Genoe, Rebecca; Culos-Reed, Nicole
Too often, informal caregivers suffer from physical pain, musculoskeletal injuries, aggravation of chronic illnesses, and other negative physical health consequences. Part of the negative impact on caregiver health may be a result of the reduced likelihood that informal caregivers engage in regular physical activity. Since nearly every Canadian will at some point in time be in the position of having to provide care for a loved one, reducing negative outcomes associated with informal caregiving represents a very large health concern. The purpose of this thesis was to investigate the effects of online Vinyasa Yoga (VY) and TaijifitTM practice and cessation on muscle strength and endurance, balance, walking speed, flexibility, and quality of life (QOL) in adult informal caregivers (≥ 18 years of age). This thesis involved two studies. Study I investigated the physical changes and QOL effects from 12 consecutive weeks of VY and TaijifitTM practice (150 minutes/week) in adult informal caregivers. Study II investigated the physical changes and QOL effects after six weeks of cessation from VY and TaijifitTM in these caregivers. For Study I, participants were randomized to one of two groups: VY (n = 16, 11 females, 5 males) or TaijifitTM (n = 13, 7 females, 6 males). Twenty-six participants who completed Study I were part of for Study II (VY: n = 14, 9 females, 5 males; TaijifitTM: n = 12, 6 females, 6 males). Prior to and following the 12-week intervention (Study I) and six-week cessation period (Study II), assessments were made for muscle strength (1-RM leg press, chest press, hand-grip), muscle endurance (leg press and chest press; maximal number of repetitions performed to fatigue at 80 and 70% baseline 1-RM respectively), abdominal endurance (maximum number of consecutive curl-ups to fatigue), tasks of functionality (dynamic balance and walking speed), flexibility (sit and reach), and QOL. ii Results from Study I showed that 12 consecutive weeks of VY and TaijifitTM increased muscle strength and endurance, indices of functionality, and flexibility (p < 0.05), with greater gains in chest press endurance (p = 0.019) and abdominal curl-up performance (p = 0.034) in the VY group compared to TaijifitTM group. Furthermore, 12 consecutive weeks of VY and TaijifitTM increased all eight QOL health domains and overall physical and mental health (p < 0.05), with TaijifitTM leading to greater gains in three QOL health domains – bodily pain (p = 0.021), general health (p = 0.005), and vitality (p = 0.018) – and overall physical health (p = 0.026) compared to VY. Results from Study II showed that all but two physical outcome measures (1-RM chest press strength, p = 0.038; chest press endurance, p = 0.024) were maintained six consecutive weeks post-exercise, with no differences between groups. Furthermore, overall physical and mental health and all but one QOL health domain (physical functioning, p = 0.029) were maintained six consecutive weeks post-exercise, with no differences between groups. These studies provide evidence that VY and TaijifitTM are effective for improving muscle strength and endurance, functionality, flexibility, and QOL in adult informal caregivers. VY led to greater gains in chest press endurance and abdominal curl-ups compared to TaijifitTM, while TaijifitTM led to greater gains in overall physical health, bodily pain, and general health compared to VY. Further, the vast majority of physical and QOL improvements were maintained after six weeks of cessation from VY and TaijifitTM. Keywords: Yoga, Tai Chi, Informal Caregiving, Strength, Endurance, Functionality, Flexibility, Quality of Life
Open Access
Experiences of Black African Formal Caregivers to Older Adults: A Qualitative Study
(Faculty of Graduate Studies and Research, University of Regina, 2019-04) Obasi, Ebere Zepherinus; Wickson-Griffiths, Abigail; Gregory, david; Bockarie, Abu; Genoe, Rebecca
This qualitative study explored the experiences of Black African formal caregivers to older adults in Saskatchewan. A purposeful sample of 20 participants from the Black African formal caregiving population was accrued from within Saskatchewan. Using qualitative descriptive approach by Sandelowski (2000, 2010) that included face-to-face interviews, the experiences of Black African formal caregivers in Saskatchewan were explored. Five themes emerged from the data including core values and fundamentals of care provided to older adults by Black African formal caregivers, provision of basic care to older adults, ancillary care, the impact of older adults with dementia on Black African formal caregivers, and challenges experienced by Black African formal caregivers. The findings revealed the participants thought caring for older adults was challenging and rewarding. The participants faced challenges especially from residents with dementia. Participants were passionate, patient, empathetic, resilient, responsible, enduring, and these qualities enabled them to deliver safe and efficient care to older adults. Religion was found to have a positive impact on the caregiving roles of the participants. It served as a coping mechanism for participants especially during challenging caregiving moments. The study contributed to the knowledge base about caring for older adults in Canada. Recommendations for policy and practice and offered suggestions for further research are noted. Keywords: Caregivers, Black African formal caregivers, experience, older adults, dementia, religion.
Open Access
Exploration of the Lived Experiences and Needs of Individuals with Adult-Diagnosed Cystic Fibrosis
(2023-11) Dollimount, Anna; Ram, Malina; Power, Hilary, A.; McKay, Corinne; Afseth, Niki; Genoe, Rebecca; Switzer, Heather; Tam, Julian; Wright, Kristi, D.
Background: Most cases of cystic fibrosis (CF) are diagnosed in infancy, however rates of adult-diagnosed CF are increasing with 5-10% of CF cases being diagnosed in adulthood [1]. Our limited understanding of this subset of the CF population is based on dated literature [2-3] and an up-to date understanding of the experiences and needs of those diagnosed in adulthood is required in order to develop age-appropriate supports to navigate the disease [4]. The purpose of present study was to examine the lived experiences and needs of those diagnosed with CF in adulthood from multiple vantage points (i.e., those with CF and CF health care providers). Methods: A qualitative research design was used. Participants (n = 16) included adults with CF (n = 8, Mage = 41.71, SD = 14.47), and interdisciplinary CF health care providers (n = 8, Mage = 46.29, SD = 7.93) recruited from CF clinics and chapters in Western Canada. Participants completed a brief demographic questionnaire and a semi-structured interview. Individual interviews ranged from 30-60 minutes in length. Interview questions included general introductory questions about informational and service needs, as well as specific questions about the benefits and drawbacks of an Internet-based resource. All interviews were audio-recorded and transcribed verbatim. Results: A thematic content analysis was completed, and five major themes were uncovered: (1) CF information needs (i.e., limited information available, limited understanding of CF); (2) challenges of having CF (i.e., diagnosis challenges, treatment challenges, social challenges); (3) emotions related to CF and coping (i.e., feeling overwhelmed, angry, worried, guilty); (4) health service needs (i.e., access, physical health, mental health); (5) online resource considerations (i.e., benefits, drawbacks, key components). Conclusions: The results highlight that those diagnosed with CF in adulthood require tailored information in crucial areas (i.e., disease knowledge, challenges, emotions, coping strategies, resources). The results also indicate that individuals with adult-diagnosed CF are in favor of information provision via an Internet-delivered resource. Information gathered from the study will be employed to inform the development of a tailored resource to address information and support needs. Acknowledgements: Supported by the Social Sciences and Humanities Research Council (SSHRC) and the SK Centre for Patient-Oriented Research (SCPOR).
Open Access
Exploring The Perspectives of West African Immigrant Families on Active Living Among Adolescent Children: A Grounded Theory of Study
(Faculty of Graduate Studies and Research, University of Regina, 2019-12) Hassan, Oluwasegun Bankole; Johnson, Shanthi; Genoe, Rebecca; Salm, Twyla; Kikulwe, Daniel; Salami, Bukola
Accumulating evidence suggests that the risks of inactivity-related problems such as obesity are becoming a population health concern among younger age groups. High income countries show an elevated rate of physical inactivity among children. Low- and middle-income countries are beginning to experience a gradual increase in this trend. Canada is a highly industrialized multicultural society with nearly 22% of foreign-born individuals coming through the immigration process. Recent immigrants tend to experience a decline in their health status, over time as their years in Canada increase (negative acculturation effect). This phenomenon can be attributed to several factors including adaptation to the new sociocultural environment. While a great deal of research has focused on children, there is paucity of research in this area among West African children in Canada. With Saskatchewan being one of the fastest growing populations in Canada, this study sought to gain a deeper understanding of the perspectives of West African immigrant families in Saskatchewan and assess the impact of the sociocultural environment on active living among their adolescent children. Using purposive sampling, a total of 15 families residing in Saskatchewan were interviewed. Children between 10 to 17 years and their parents were interviewed in each family. A grounded theory methodological approach by Charmaz (2014) was used in this study. This involved an immersion phase, a conceptual phase, and a constant comparative analytical process. The analysis allowed for emergence of themes. Both the children and their parents reported having experiential knowledge of physical activity and benefits. The children and their parents also showed some negative acculturative experiences associated with active living. They reported facilitators of physical activity for the children such as school influence, peer influence, and parental role-modelling. The children showed an inherent interest in engaging in risky play. Both the children and their parents reported beneficial outcomes of engaging in physical activity together as a family. Finally, parental positive and negative reinforcements was reported in relation to domestic activities. This study contributes to a conceptual understanding of the knowledge regarding internal, external, and transitional factors impacting the active living and well-being of West African children in Canada.
Open Access
"A Grip and a Dream": Voices of Older Carribean Immigrant Women in Saskatchewan, Canada
(Faculty of Graduate Studies and Research, University of Regina, 2022-03-30) Watson-Jones, Peta-Gay; Durst, Doug; Genoe, Rebecca; Pino, Fritz; Puplampu, Vivian
This hermeneutic phenomenological study integrates transnational feminism to describe the lived experiences of older Caribbean immigrant women living in Saskatchewan, who immigrated to Canada in early adulthood in the 1960s to1980s. A purposive and snowball recruitment method was used to select ten female participants that were interviewed. The participants' ages range from 65 to 83 years. To assess the impact of social relationships on aging and quality of life this study used in-depth, individual, and semi-structured interviews for data collection. The data collected were audio-taped followed by the transcription and data analysis. Field notes and reflexivity were documented to assist with the data analysis which followed hermeneutic phenomenology and interpretative phenomenological analysis (IPA). The objective of this study is to provide a clearer understanding and further knowledge of older immigrant women perceptions of social relationships and its impact on aging, and their quality of life. Social relationships play an integral role throughout the lifespan of these women. Their perceptions about social relationships, aging, and quality of life emerged in four primary themes: (1) perceived social relationships; (2) transnational migration; (3) perceived racial discrimination and (4) aging and quality of life across the lifespan. The study’s findings indicate that forming strong social relationships contributed to good quality of life among older Caribbean immigrant women as they aged in Canada. Also, it was further revealed that social relationships and social networks formed with family, fellow Caribbean natives, and friends within their community provided emotional support throughout their lifespan which helped to ward off social isolation and loneliness. Additionally, those with good health perceive their quality of life as they age as being good while others with poor health perceive their quality of life as poor. Presumably, this study illustrates key aspects of social relationships, and quality of life of older Caribbean immigrant women who have aged in Canada. Moreover, this research will contribute to gerontological literature, inform policy, and the development of interventions that are culturally sensitive to foster social relationships among immigrant women living and aging in Canada. Future research should examine Caribbean immigrant men and women living in the different provinces to better understand both genders’ experience of how they formed social relationships and specifically how these relationships impact their quality of life. Keywords: Social relationship, Aging, Quality of life, Caribbean immigrants, Transnational migration, Transnational feminism
Open Access
How Spirituality Training impacts the Practice of Social Workers Assisting Elderly Clients in End-of-Live Care: A Hermeneutical Phenomenological Approach
(Faculty of Graduate Studies and Research, University of Regina, 2015-03) Goldberg, Michael Jordan; Genoe, Rebecca; Hampton, Mary; Novik, Nuelle; Wagner, Joan
Social workers in end-of-life care settings are presented with many challenges. They are not only confronted by the common stressors associated with death and dying, but also with the existential concerns of the patients and their families. Social workers typically outnumber spiritual advisors or chaplains in a hospice palliative care unit, and therefore have more frequent exposure to these needs of the patients. As an elderly patient, in particular, approaches end-of-life, the notions of religion and spirituality can take on a more significant role in acceptance of mortality. Social workers have reported reluctance in addressing the spiritual matters of their patients and have also expressed feeling ill equipped to deal with these issues. Spirituality training seminars have been linked with significant improvements in self-perceived compassion for the dying, compassion for oneself, and in reducing work-place stress. The research goal for this project was to seek to understand how spirituality and current spirituality training impacts the practice of social workers assisting elderly clients in end-of-life care settings. A secondary goal of this study was to explore the phenomenon of what it is like to deliver spiritual care as an end-of-life care social worker. A tertiary goal was to define and describe the nature of spirituality as social workers in hospice and palliative care settings conceive of it today. This study employed a hermeneutic phenomenological research approach (Gadamer, 1998) to explore the experience of five social workers in a local hospice/palliative care setting utilizing spirituality training with their elderly clients. Participants were sampled based on convenience from the cities of Winnipeg and Regina. Themes relating to the impact of spirituality training on participants’ practice emerging from the data include: feeling poised in difficult circumstances, appreciating different perspectives, complementing innate skills, and perception of greater connection. The themes emerging from data relating to how participants experience delivery of spiritual care include: being curious and aware, listening and being present, and drawing on interdisciplinary teams. Finally, the main themes expressing how participants describe spirituality are: the disparity between spirituality and religiosity, belief in a greater power, feeling of connectivity, and the pursuit of meaning and purpose. The conclusions of this research help to illuminate how spirituality training exercises are implemented in practice, as well as provide a better understanding of how spirituality education could be integrated into the post-secondary curriculum of social work study.
Open Access
Informing the Development of an Internet-delivered Mental Health Program for Youth with Cystic Fibrosis: A Qualitative Study
(Faculty of Graduate Studies and Research, University of Regina, 2019-09) Power, Hilary Ann; Wright, Kristi; Klest, Bridget; Loucks, Jeff; Genoe, Rebecca; Urban, Ann-Marie
Youth with cystic fibrosis (CF) and their parent caregivers have been shown to experience elevated psychological symptoms. The need to address these issues through providing appropriate information and services to this population is evident. At present, there is no specific mental health program designed for youth with CF in Canada. The current study qualitatively examined the information and service needs of youth with CF. Participants (n = 16) included five youth with CF (Mage = 9.40, SD = 1.01), seven parent caregivers (Mage = 36.43, SD = 3.46), and four CF health care professionals (Mage = 44.00, SD = 10.46) recruited from CF clinics and chapters in Saskatchewan, Canada. Participants completed a brief demographic questionnaire. Semi-structured individual interviews were conducted with all participants. Thematic content analysis was used to analyze the data collected for each participant group. Four major themes were uncovered from youth participant responses: (1) challenges living with CF, (2) building independence, (3) coping, (4) bridging gaps in services. Six major themes were uncovered from parent participant responses: (1) emotional challenges (2) social challenges, (3) demanding treatments, (4) coping, (5) encouraging independence, and (6) improving services. Six major themes were uncovered from health care professional participant responses: (1) emotional challenges, (2) social challenges, (3) lifestyle restrictions, (4) developing independence, (5) barriers to care and managing CF, and (6) focusing on future mental health care. The findings highlight the many challenges experienced by youth with CF and their families. The results also draw attention to the importance of providing effective support in managing and coping with CF. Information gathered in the present study will be later used, in combination with the empirical literature, to inform the development of an evidence-based, Internet-delivered mental health program for this population.Keywords: Cystic fibrosis, psychopathology, children, adolescents, Internet intervention, mental health, qualitative design
Open Access
Intimate Partner Abuse and Older Women: Exploring the Connection Between Abuse, Ageing and Health
(Faculty of Graduate Studies and Research, University of Regina, 2018-03) Taylor, Meagan Lee; Hampton, Mary; Wagner, Joan; Genoe, Rebecca; Durst, Douglas
Intimate Partner Abuse (IPA) has been shown to negatively affect health in ageing women (McGarry et al., 2010). As the population in Canada matures, understanding how IPA affects and intersects with health and ageing becomes important for women, our health care system and governments. This research explores perspectives of women over 65, who have experienced IPA in an earlier stage of their lives, and how this experience intersects and affects with their health and ageing. The experiences of ten women who have lived through IPA relationships are investigated using the qualitative method of grounded theory. The significance of this research is three-fold. First, it serves to generate awareness about women’s perceptions of their own health and aging processes following IPA. Second, it adds to what is known about older women who have experienced abuse. And finally, this research has the potential to improve health care for older women who have experienced abuse.
Open Access
Leisure Spaces and leisure Constraints for Lesbian Women
(Faculty of Graduate Studies and Research, University of Regina, 2015-07) Barbosa, Carla Alexandra; Liechty, Toni; Genoe, Rebecca; Anderson, A. Brenda; Mock, Steve E.
Researchers have argued that leisure and leisure spaces are gendered, differentiating men and women in their opportunities for and outcomes of leisure (e.g., Aitchison, 1999; Henderson & Shaw, 2006). Gender expectations generate leisure constraints especially for women (Shaw et al., 1991). Furthermore, within the female group, lesbians face additional constraints because of the intersection of sexism with homophobia (Pritchard et al., 2002; Taylor, 2007). In 2011, I conducted an online pilot study with a sample of 813 lesbians which suggested that for most participants, self-consciousness and fear of harassment prevented them from fully enjoying their leisure in public spaces. This is of particular concern because studies have suggested that the provision of leisure in gay-friendly environments can be an important tool to help lesbians cope with marginalization and stress (Skeggs, 1999; Iwasaki & Ristoki, 2004). Research into the meaning of leisure for lesbians; however, is scarce and little is known about leisure spaces that are specifically designed for (rather than simply tolerant of) people in the LGBTQ community. The purpose of this phenomenological study was to explore the experiences of lesbians who attend a straight-friendly church in order to investigate the characteristics of the leisure setting and the meanings attributed to their leisure experiences. Participants were 7 women recruited from the church who completed semi-structured interviews. The data was digitally recorded, transcribed verbatim and analyzed thematically. Participants described the church as a leisure space that played an important role in their lives. Themes emerged related to the church as a leisure space including: emotional healing and spiritual expression; community building in diversity; network for leisure activities; and institutionalized and internalized homophobia. Participants also reported that religious beliefs disseminated both in churches and in society were constraints that strongly impacted their wellbeing and their experiences in leisure. Themes related to leisure constraints included: churches and religion as leisure constraints; partners as leisure constraints; and homophobia and self-consciousness. These results support the literature that discusses the relevance of LGBTQ oriented leisure spaces to help lesbians create coping mechanisms against homophobia. The findings indicated that there is a great need for further exploration of leisure for lesbian women, particularly leisure that promotes emotional healing and community building. Findings also indicate that spaces with spiritual characteristics might be more empowering for lesbian women than bars and gay neighborhoods. The study concludes with suggestions for stakeholders, limitations of the study and directions for future research.
Open Access
Life History, Nurse Empathy, and Aggressive Behaviours in Individuals with Dementia
(Faculty of Graduate Studies and Research, University of Regina, 2014-11) Eritz, Heather Sharlene; Hadjistavropoulos, Thomas; Hampton, Mary; Wright, Kristi; Genoe, Rebecca; Carleton, R. Nicholas; Hirst, Sandra
Dementia is common among long term care (LTC) residents and has many implications for their quality of life. Individuals with dementia often present with behavioural disturbances such as aggression (e.g., destructive actions toward persons, objects, or the self) that negatively affect their quality of life and may result from unmet needs (Whall et al., 2008). Egan et al. (2007), using a very small patient sample (N = 4; no control group), successfully piloted an intervention intended to influence professional caregivers’ behaviour toward residents, and thus decrease aggressive behaviours by presenting staff members with life histories of the residents. The goal of these life histories was to increase staff perceptions of patient personhood with the outcome of improving person-centered care. The current study was designed to replicate the intervention designed by Egan et al. (2007) with a larger number of participants and a control group. Within a framework of the Functional Analytic (FA) model (Fisher, Drossel, Ferguson, Cherup, & Sylvester, 2008), it was expected that changes in nurse behaviour toward the residents would lead to changes in behavioural disturbance and specifically decreases in aggressive behaviour and increases in quality of life for the residents. It was also expected that these changes in nurse behaviour would stem from increases in empathy and personhood perception. As such, perceptions of empathy and personhood would serve as mediators for the expected changes in aggressive behaviours and quality of life. Significant differences between the experimental and control groups were found following the intervention. These changes were reflected in aggressive behaviours, personhood perception, and quality of life. Mediation analyses found a significant mediated effect, with personhood perception serving as a mediator for quality of life. Additional analyses revealed a significant negative relationship between patient cognitive impairment and staff personhood perception prior to the intervention, at intervention, and at follow-up. Finally, qualitative analyses explored the attitudes staff members have toward residents and their perceptions of resident personhood. The implications of these findings are discussed.
Open Access
Moral Agency and Moral Distress Among Registered Nurses: Novice to Expert
(Faculty of Graduate Studies and Research, University of Regina, 2018-07) Fortier, Elisabeth Pauline; Malloy, David; Gregory, david; Fistein, Elizabeth; Genoe, Rebecca; Gillespie, Michael
In everyday practice, nurses encounter moral dilemmas that can potentially impact patients’ quality of care. A nurse exercising moral agency makes ethical decisions based on core values and moral principles. Moral agency has roots in existential philosophy; it can significantly impact the organizational role of nurses, the healthcare system, and patients. The relationship between a moral agent and the institution in which they practice has been labeled the most challenging moral problem of our century. Moral distress can be precipitated by a diminished sense of moral agency. Understanding moral agency in a bureaucratic system like healthcare is necessary to comprehend ethical issues and moral distress experienced by nurses. In this thesis, I, the researcher, explored moral agency and moral distress as experienced by twenty registered nurses (RNs). The distinctions between Novice and Expert RNs were based on years of experience and the work of Benner (1984). Participants were recruited using purposive sampling and a modified snowball sampling technique and face to face interviews were subsequently conducted. De Groot’s methodology (1964) was used as a framework for the study, interviews as the method of data collection and thematic content analysis was used to analyze data. Findings reveal the organizational factors (understaffing, heavy workloads, and time) limiting nurses’ moral agency and potentially leading to moral distress. The three major themes are “Organizational Context: Factors impeding Moral Agency and leading to Moral Distress among RNs”, “Growth of Moral Agency: How RNs develop voice”, and “Moral Agency and Moral Distress in End of life Care”. The themes also touch on the differences and similarities between Novice and Expert RNs as I anticipated differences based on the work of Benner (1984). This distinction was important as I suggest moral distress and moral agency may be different based on experience. The study suggests RNs strive to be moral agents, but often face limitations in exercising moral agency in their profession. This research makes an original contribution to knowledge in the field of healthcare ethics as it is the first study of its kind on moral agency and moral distress among RNs in Canada.
Open Access
Nutritional and Fall Risk Among Older Women Living in Long-Term Care Facilities of India
(Faculty of Graduate Studies and Research, University of Regina, 2017-06) Madan, Swati; Johnson, Shanthi; Neary, Patrick; MacLennan, Richard; Genoe, Rebecca; Duvvuru, Jamuna
The objectives of the study were to assess the nature of nutritional and fall risk in older adults living in LTC facilities in New Delhi, evaluate the inter-relationship of nutritional and fall risk, and assess whether depression, fear of falling, and physical function predict fall risk, and to test the reliability of nutrition and fall risk measures. Eighty five women aged 60 years and over living in six LTC facilities in New Delhi were recruited. Measures included the Mini Nutritional Assessment (MNA), Falls Efficacy Scale International (FES-I), Downton Index, SF-36 Health Survey, Geriatric Depression Scale (GDS), Mini Mental State Exam (MMSE), and a background profile and physical activity questionnaire. Mobility was assessed using Timed up and go test (TUG), and handgrip strength was assessed using Jamar hydraulic hand dynamometer. Using SPSS software (version 22.0), descriptive statistics, correlation between different variables, predictors of fall risk, and reliability measures were analysed. The mean age of participants was 74.21(5.52) years. A majority were widowed with poor educational and income level. Findings revealed that 54% of the older women were at a high level of nutritional risk. The factors that accounted for a large proportion of variance in the nutritional risk level were mobility status, intake of psychotropic medications, low dietary intake, and poor self-perception of health status. MNA scores had significant negative correlation with Downton Index scores (R= -.419, p<.001) which implies that higher MNA scores (lower nutritional risk) were associated with lower scores on Downton Index (lower fall risk). Multiple regression analysis revealed that fear of falling, fall history, body pain, functional mobility, gait condition, and depression were predictors of fall risk. Analysis of the psychometric properties of the main constructs showed that the reliability of MNA was low (Cronbach’s alpha= 0.3) while the reliability of Downton Index was fair but acceptable (Cronbach’s alpha=0.7). The study highlights the burden of nutritional and fall risk among older adults living in LTC in India, the need to establish the psychometric properties of tools for various cultural contexts, and plan intervention studies to address this significant co-existing health issue.
Open Access
Perceptions and experiences of leisure-time physical activity among older adults following a heart attack
(Faculty of Graduate Studies and Research, University of Regina, 2023-07) Sultana, Sabiha; Genoe, Rebecca; Kelsey, Roz; Kulczycki, Cory; Wickson-Griffiths, Abigail
Leisure has been found to improve later-life well-being and to help people in coping with life changes (Dupuis & Alzheimer, 2008; Michèle et al., 2019). Leisure activities, including leisuretime physical activity, may significantly affect healthy aging and improve health-related quality of life among older persons. However, there is a lack of literature revealing the determining factors of participation in leisure-time physical activity among older adults following a heart attack. The aim of this research was to explore the perceptions and experiences of leisure-time physical activity among older people who have had a heart attack. To obtain participants’ perspectives, a parallel mixed-methods design was used. Data were collected from 10 participants using a survey (Rapid Assessment of Physical Activity questionnaire) to measure leisure-time physical activity, followed by a face-to-face interview. A qualitative descriptive technique was used to guide the qualitative data collection and analysis. SPSS version 25.0 was used to analyze the demographics and the RAPA questionnaire. Thematic analysis was used to analyze the qualitative data. Four main themes, making lifestyle changes after a heart attack, engagement in leisure-time physical activity, perceptions about leisure-time physical activity after a heart attack, and constraints were generated to describe participants’ perceptions and experiences of leisure-time physical activity. Leisure-time physical activity participation after a heart attack was influenced by several motivators which led to engagement in leisure activities. Participants experienced several constraints in engaging in leisure-time physical activity, however, they described different ways of negotiating those constraints.
Open Access
Population Aging and Long-Term Care Policy Change in Canada: A Comparison of British Columbia, Manitoba, and Ontario
(Faculty of Graduate Studies and Research, University of Regina, 2014-11) Harris, Jonathan Brody; Marchildon, Gregory P.; Zarzeczny, Amy; Mou, Haizhen; Genoe, Rebecca
Introduction: Residential long-term care (LTC) is an important component of the care continuum for older adults in Canada. Three factors related to population aging are contributing to an increased demand for LTC services: 1) an increased prevalence of age-related health disorders; 2) reduced societal capacity to provide unpaid care; and 3) a lack of available substitutes for LTC. LTC is not one of Medicare’s insured services and as such great variation in the provision of LTC services exists across provinces. Provincial governments are currently grappling with how best to provide and pay for quality LTC services while also weighing investment in other aspects of the care continuum to delay or prevent LTC admission. Purpose: The purpose of this thesis is to examine LTC policy changes since 1990 and the impact these have had on LTC spending and quality in three provinces that represent natural policy experiments: British Columbia, where a disinvestment in LTC and concurrent investment in assisted living has taken place; Manitoba, one of the largest per capita spenders on both LTC and home care; and Ontario, which has essentially maintained the status quo. Methods: A retrospective comparative case study approach adapted from the work of Richard Rose (2005) is used to compare provincial experiences. Evidence was drawn from a comprehensive literature review of not only peer-reviewed literature but also grey literature, including policy and planning documents and advocacy group and think-tank reports. Descriptive analysis was performed on spending data obtained from the Canadian Institute for Health Information’s National Health Expenditures Database, and Quality data obtained from the Canadian Institute for Health Information’s Continuing Care Reporting System. Results: British Columbia’s strategy of investment in assisted living in lieu of LTC resulted in substantial cost savings since the early 2000s. LTC quality was best in Manitoba, where the per capita spend on LTC is highest, although resident populations varied slightly between provinces. Conclusions and Recommendations: While British Columbia has successfully reduced costs in the LTC sector by substituting assisted living, there is some evidence to suggest that this approach may create barriers to access and lead to downward pressures in other parts of the health system, particularly acute care. Investment in a robust continuum of care that includes support for informal carers, home care, respite care, assisted living, and LTC where appropriate seems the best way to meet the needs of the aging population while providing affordable and high quality LTC. Additionally, paradigms such as aging in place, although well-intentioned, may be misused by governments to achieve policy ends and can be a barrier to effective reform in the LTC sector. Keywords: Long-term care, continuing care, aging, health policy, health services.
Open Access
A Qualitative Exploration of the Information and Service Needs of Youth Siblings of Individuals with Cystic Fibrosis
(Faculty of Graduate Studies and Research, University of Regina, 2020-06) Shivak, Shelby Marie; Wright, Kristi; Gordon, Jennifer; Loucks, Jeff; Genoe, Rebecca; Matthews, Elise
Cystic Fibrosis (CF) is a progressive, fatal inherited disease common amongst Caucasian children and young adults in Canada. In addition to being one of the most difficult chronic health conditions to manage, siblings of children and adolescents with CF have been shown to experience elevated psychological symptoms (e.g., depression and anxiety), negative social adjustment, and internalizing behaviours. While the need to address these concerns by providing appropriate information and services is evident, to date there are no tailored mental health programs designed for siblings of children and adolescents with CF. There were five main objectives for the present research: To explore (1) what challenges healthy siblings of youth with CF face, (2) what information about CF healthy siblings of youth with CF need, (3) what types of mental health services healthy siblings of youth with CF need, (4) the perceived benefits and/or drawbacks of obtaining services via the Internet, and (5) what components should be included in an interactive, Internet-delivered mental health prevention program for healthy siblings of youth with CF. Participants (n = 10) included four youth siblings of pa Mage = 36.67, SD = rent caregivers ( a six nd w Mage = 10.25, SD = 2.77) ith CF ( yout h 3.40) recruited from CF clinics and chapters in Saskatchewan, Canada. Siblings and parent caregivers completed brief demographic questionnaires and participated in individual semi-structured interviews. Thematic content analysis was used to analyze the data collected from each participant group with reference to the main study objectives. Sibling participant responses uncovered four major themes: (1) life balance, (2) emotional challenges, (3) coping, and (4) bridging gaps in sibling care. Parent responses uncovered six major themes: (1) life balance, (2) emotional challenges, (3) coping, (4) developing and maintaining relationships, (5) education, and (6) improving mental health services. The results of the present study highlight the unique challenges experienced by siblings and families of youth with CF and the need for effective family support in coping with CF. Information obtained from the study will be used to inform the development of an evidence-based, Internet-delivered mental health program aimed at improving the overall mental health functioning and quality of life of this population.
Open Access
Recovery from Deliberate Self-Harm: Perspectives from Those Who Have Survived and From Those Who Have Helped
(Faculty of Graduate Studies and Research, University of Regina, 2015-11) Gelinas, Bethany Lee; Wright, Kristi D.; Carleton, R. Nicholas; Genoe, Rebecca; Klest, Bridget; Klonsky, E. David
Interventions for adolescents who engage in deliberate self-harm are notoriously challenging and negligibly effective. Self-harming adolescents often keep their behaviours a secret, do not see their self-harm as a problem, and rely heavily on parents and friends for support and assistance in help-seeking. In fact, social support, particularly via friends and family members, has been identified as one of the most crucial components to self-harm recovery. Although parents and friends are vital to help-seeking and recovery, little is known about the lived experience of parents and friends in supporting someone who self-harms. What little is known indicates that parents and friends struggle with self-harm, as they feel uninformed, unsupported, and often overwhelmed. Mental health professionals and programs would do well to capitalize on the existing primary sources of social support; however, a better understanding of their experiences, perceptions, and struggles are required first. The current study transpired through three stages, involving in-depth interviews with: (1) 10 individuals who have recovered from adolescent self-harm, (2) 10 friends of recovered individuals, and (3) 10 parents of recovered individuals. The current study addressed three main objectives: (1) elucidating the perspective and experience of individuals who have recovered from self-harm, particularly in terms of help-seeking, recovery, and their support needs, (2) elucidating the perspective and experience of friend-caregivers, and (3) elucidating the perspective and experience of parent-caregivers. By examining the retrospective perceptions of recovered individuals, we have gained insight into the wants and needs of a sub-population that is often secretive and uncommunicative. The current study reports on recovered individuals’ experiences with parental involvement, friend involvement, help-seeking, recovery, and support needs. In turn, by examining the perspectives of caregivers, we can gain insight into the wants and needs of the social support system that is in the best position to aid and support self-harming individuals. The current study reports on caregivers’ experiences in the caregiving role, actions in the caregiving role, and perceived support needs. The following key messages were reported across participant groups and were derived from recovered individuals’, friend-caregivers’, and parent-caregivers’ lived experiences. First, direct communication about self-harm is essential to the recovery process. Second, viewing self-harm as an attention-seeking behavior is disadvantageous. Third, self-harm has a widespread and longstanding influence for self-harming individuals as well as caregivers. Fourth, supports are desperately needed for both adolescents and their caregivers throughout the recovery process. Fifth, school systems are integral to improving education and awareness about self-harm. Sixth, psychoeducational support groups are believed to hold widespread treatment potential for adolescents as well as caregivers. The knowledge gained can be used to better inform and implement prevention and treatment strategies for self-harming individuals, as well as for caregivers. Gaining a multidimensional perspective on the self-harm dilemma provides a more comprehensive overview of support opportunities and potential clinical innovations. The corroboration and consensus provided across recovered individuals, friend-caregivers, and parent-caregivers helps focus future directions. In sum, by learning from the experiences of individuals who have lived through the process of recovery from self-harm, the current study augments our understanding of the process, and directs future research and clinical interventions.