Browsing by Author "Malloy, David"

Now showing 1 - 14 of 14

Open Access
A platonic perspective of health care: An interpretative-theoretical model.
(Faculty of Graduate Studies and Research, University of Regina, 2004) Robert, Jo-Ann Louise; Malloy, David
Open Access
A Scoping Review of the Components of Moral Resilience: Its Role in Addressing Moral Injury or Moral Distress for High-Risk Occupation Workers
(Springer, 2023-12-14) Osifeso, Temitope; Crocker, Sierra J.; Lentz, Liana; Smith-MacDonald, Lorraine; Seliman, Merna; Limenih, Gojjam; MacPhee, Renée S.; Anderson, Gregory S.; Brémault-Phillips, Suzette; Malloy, David; Carleton, R. Nicholas
Purpose of Review: High-risk occupation workers (HROWs) are often exposed to potentially morally injurious events (PMIEs) which can contribute to moral distress (MD) or moral injury (MI). Moral resilience (MR) has been proposed as a protective or moderating factor to protect HROWs from harm caused by PMIE exposures. The current review was designed to: 1) update the definition of MR to a broader context of HROWs; 2) identify components of MR for HROWs; and 3) determine demographic variables that may impact MR development.
Open Access
An Agent-Based Wellness Visualization System
(Faculty of Graduate Studies and Research, University of Regina, 2013-05) Soomlek, Chitsutha; Benedicenti, Luigi; Chan, Christine; Paranjape, Raman; Malloy, David; Migliardi, Mauro
This research presents the conceptual design of a personal wellness indicator and the proof of concept. An agent-based wellness indicator is an information visualization system designed to present wellness information to people in a simple graphical format complemented by anomalies found, simple descriptions, suggestions and supporting tools. The visualization system is designed to give people a better understanding of their wellness conditions and fast access to relevant information, which could potentially help them improve their wellness levels. The wellness and decision-support information of individuals are also visualized to their caregivers by elaborating the data provided by existing resources. The wellness indicator system is constructed from an operational wellness model we developed. The model allows an automatic measuring system to calculate the wellness level for a number of indicators resulting in an overall wellness level. These results can be presented in a simple graphical format. The proof of concept is developed by utilizing the unique characteristics of software agents. The software has been evaluated by following the steps provided in the framework for testing a wellness visualization system. The evaluation is carried out by both general users and healthcare professionals. The results show positive feedback on various aspects of the wellness visualization system. In addition, the results confirm that the wellness indicator system can help people have a better understanding of their personal state of well-being and can support healthcare professionals delivering wellness services.
Open Access
Compromised Conscience: A Scoping Review of Moral Injury Among Firefighters, Paramedics, and Police Officers
(Frontiers Media, 2021-03-31) Lentz, Liana; Smith-MacDonald, Lorraine; Malloy, David; Carleton, R. Nicholas; Brémault-Phillips, Suzette
Background: Public Safety Personnel (e.g., firefighters, paramedics, and police officers) are routinely exposed to human suffering and need to make quick, morally challenging decisions. Such decisions can affect their psychological wellbeing. Participating in or observing an event or situation that conflicts with personal values can potentially lead to the development of moral injury. Common stressors associated with moral injury include betrayal, inability to prevent death or harm, and ethical dilemmas. Potentially psychologically traumatic event exposures and post-traumatic stress disorder can be comorbid with moral injury; however, moral injury extends beyond fear to include spiritual, cognitive, emotional or existential struggles, which can produce feelings of severe shame, guilt, and anger.
Open Access
Discourse Fall 2016 Winter 2017
(External Relations, University of Regina, 2016-09-28) Malloy, David; Baliko, Krista; Campbell, Greg; Graham, Rae; Hopkin, Trevor; Johnson, Dale; Johnston, Elsa; Maragos, Costa; Mitchell, Dave Oswald; Sproat, Deborah; Limacher, Erin
02 Vice President (Research) Message 03 Editor’s Message 04 Student Focus 07 Innovation Award: Impacting the lives of seniors 08 Bridging the gap: Research seeks to understand FASD 12 Battling bacteria: The fight against antibiotic resistant microbes 18 By The Book 20 Funding 22 Collaborate 24 Leading the way in Indigenization
Open Access
Discourse Fall 2017 Winter 2018
(External Relations, University of Regina, 2017-11) Baliko, Krista; Cormack, Katherine; Malloy, David; Carriere, Jocelyn; Dorma, Everett; Graham, Rae; Hopkin, Trevor; Johnson, Dale; Maragos, Costa; Mitchell, Dave Oswald; Pacholik, Devin; Schlamp, Colette; Sproat, Deborah
02 Vice President (Research) Message 03 Student Focus 06 Dugouts 07 Accolades 08 Loaded Dice 12 Machine Learning 17 Projecting Future Climate Change 18 By the Book 20 Funding 22 Collaborate
Open Access
Discourse Fall 2018 Winter 2019
(External Relations, University of Regina, 2018-11) Baliko, Krista; Cormack, Katherine; Malloy, David; Andrusieczko, Tanya; Bell, Michael; Bowness, Suzanne; Duck, Greg; Graham, Rae; Hopkin, Trevor; Johnson, Dale; Pacholik, Devin; Schlamp, Colette; Tewksbury, Jon
02 Vice-President (Research) Message 03 Student Focus 06 A Focus on Financial Well-Being 10 How Guatemalan Contract Killers Fuel the Canadian Economy 15 Eqality in the Face of Disaster 16 By the Book 18 Funding 20 Collaborate 23 Fake News: Separating Fact from Fiction 24 Accolades
Open Access
Discourse Spring/Summer 2017
(External Relations, University of Regina, 2017-06) Baliko, Krista; Limacher, Erin; Malloy, David; Dorma, Everett; Graham, Rae; Hopkin, Trevor; Johnson, Dale; Maragos, Costa; Schlamp, Colette; Sproat, Deborah; Warden, Kathryn
02 Vice President (Research) Message 03 Editor's Message 04 Student Focus 07 Survival of the Kula Trade 08 Health Research with Impact 14 By the Book 16 Indigenous Research Day 17 Accolades 18 Funding 22 Collaborate 24 Riding Through Walls
Open Access
Discourse Spring/Summer 2018
(External Relations, University of Regina, 2018-05) Baliko, Krista; Cormack, Katherine; Malloy, David; Andrusieczko, Tanya; Bell, Michael; Dorma, Everett; Graham, Rae; Hopkin, Trevor; Johnson, Dale; Kies, Richard; Longman, Nickita; Maragos, Costa; Ruddy, Evie; Schlamp, Colette
02 Vice-President (Research) Message 03 Student Focus 06 Queering the Queen City 11 Accolades 12 Examining the Sixties Scoop and Beyond 17 Aging well on the Prairies 18 By the Book 20 Funding 22 Collaborate 24 Pinstripes on the Prairies
Open Access
The Impact of Patient Assessments on nurse Fears, Patient Falls, and Functional Ability in Seniors with Dementia
(Faculty of Graduate Studies and Research, University of Regina, 2013-07) Fitzgerald, Theresa Gloria; Hadjistavropoulos, Thomas; Alfano, Dennis; Wright, Kristi; Sykes Tottenham, Laurie; Malloy, David; Scudds, Rhonda; Konnert, Candace
Falls are a highly prevalent problem and a leading cause of pain among older adults (Hawk, Hyland, Rupert, Colonvega, & Hall, 2006; Proctor & Hirdes, 2001). For some individuals, actual or potential pain and falls lead to the development of fear of pain and fear of falling. It has been suggested that fears regarding pain and falling increase the likelihood of experiencing a subsequent fall and related pain (Brummel-Smith, 1989). Fear-avoidance models of pain and falls suggest that individuals who are afraid of pain and falling are more likely to engage in avoidance behaviours, which may result in deconditioning. This deconditioning, in turn, may result in increased risk for experiencing pain and falls (e.g., Vlaeyen & Linton, 2000). Support has been found for a direct relationship between fear of falling and falls, suggesting that fear has a negative effect on postural control (Carpenter, 2006). Hadjistavropoulos and colleagues (2004) proposed a modified fear-avoidance model for seniors with dementia in which caregiver fears and worries about their care-recipient experiencing falls and pain are thought to be linked to activity restrictions among care-recipients. Previous research with seniors in long-term care facilities (LTC) has led to support for the extension of the model to caregivers (Dever Fitzgerald, Hadjistavropoulos, & MacNab, 2009). This study extended previous research by examining fall risk in a subset of LTC residents based on a physiotherapy and a cognitive battery and actual fall rate. Seniors with dementia from 26 LTC facilities were randomized to control (care as usual) and experimental (fall risk assessment) groups. For the experimental group, all nursing staff were given residentspecific feedback regarding each care recipient's level of fall risk based on the assessment. Nurses’ fears about patient falls, as well as falls and restraint use were tracked for the four month periods that preceded and followed the assessment. Prior to the assessment, nurses’ fears about patient falls were found to be related to restraint use in both groups. Given that previous research has established that nurses' fears about patient falls are not always related to physical risk for falls (Dever Fitzgerald et al., 2009), such nurse fears may be excessive and therefore lead to unnecessary restraint use. Post-assessment, no relationship was found between nurses’ fears about patient falls and restraint use in the experimental group, suggesting that nurses may be basing their decisions to restrain residents on more objective criteria rather than their fear. Not surprisingly, restraint use was associated with decreased ability to perform activities of daily living (ADLs). Fall rates did not differ between the two groups. Implications and directions for future research are discussed.
Open Access
Meat in a Seat: A grounded theory study exploring moral injury in Canadian public safety communicators, firefighters, and paramedics
(Multidisciplinary Digital Publishing Institute, 2021-11-19) Smith-MacDonald, Lorraine; Lentz, Liana; Malloy, David; Brémault-Phillips, Suzette; Carleton, R. Nicholas
The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of “frustrating moral expectations” emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated their moral frustrations through both integrative and disintegrative pathways, resulting in either needing to escape their moral suffering or transforming ontologically. The current study results support MI as a relevant concept for frontline PSP. Given the seriousness of PSP leaving their profession or committing suicide to escape moral suffering, the importance of the impact of MI on PSP and public safety organizations cannot be ignored or underestimated. Understanding the similarities and differences of morally injurious exposures of frontline PSP may be critical for determining mental health and resilience strategies that effectively protect PSP.
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
Randomized Controlled Feasibility Trial of a Self-Help Book for Health Anxiety
(Faculty of Graduate Studies and Research, University of Regina, 2012-03) Bovell, Candice Vanessa; Asmundson, Gordon; Hadjistavropoulos, Heather; MacLennan, Richard; Malloy, David; Norton, G. Ron
The purpose of this feasibility study was to determine the efficacy of a cognitive-behaviour therapy (CBT) self-help book for health anxiety titled, It’s Not All in Your Head (Asmundson & Taylor, 2005) relative to a wait-list control. It was hypothesized that using a CBT self-help book would be a more efficacious treatment than wait-list control. Health anxiety is marked by anxious preoccupation about having a physical disease, based on the catastrophic misinterpretation of innocuous bodily sensations. It is associated with unpleasant physiological, behavioural, cognitive, and affective symptoms. When elevated, health anxiety affects an individual‘s interpersonal relationships, especially with his or her doctor, and increases health utilization of primary care, diagnostic tests, and secondary care resources (Conradt, Cavanagh, Franklin, & Rief, 2006). Although once regarded as a chronic disorder resistant to treatment and often associated with a poor prognosis (Avia, Ruiz, Olivares, & Crespo, 1996; Barsky, Bailey, Fama, & Ahern), there are now several empirically-supported treatment options (Taylor, Asmundson, & Coons, 2005). In particular, CBT treatments that aim to identify maladaptive thoughts and behaviours and replace them with healthy and adaptive ones, have been proven effective, and are the treatment of choice for many (Furer, Walker, & Freeston, 2001). The development of CBT programs for treating elevated health anxiety has progressed to the point where widely accessible self-help options are available. In this trial, 14 volunteers experiencing health anxiety were recruited. Participants were randomly assigned to either an 8-week self-help book treatment (SHB; n = 10) during which they read the self-help book and received therapist guidance sessions or an 8-week wait-list control group (WLC; n = 4). Health anxiety, depression, and general health symptoms were assessed at pre-, mid-, and post-treatment. T tests were used for statistical analyses and intention-to-treat analyses were employed. Relative to WLC, SHB participants reported minor reductions in health anxiety symptoms after 3 weeks of treatment and significant reductions in health anxiety and depression symptoms post-treatment. Unfortunately, due to the small sample size and lack of statistical power, some analyses could not be performed. These findings provide preliminary support the trial hypothesis and can be used to inform a future, large-scale, randomized controlled trial. Participants had mostly positive feedback about the treatment, but reported difficulty completing treatment in 8 weeks and a poor therapeutic alliance. Procedural difficulties were encountered during the trial that limit the generalizability of the results. A clinically supported, CBT-based, self-help treatment for health anxiety will potentially improve the psychological and social lives of many individuals and reduce the financial and time expenditures of mental health care providers.
Open Access
Women Past Menopause: Learning from the Voice of Experience
(Faculty of Graduate Studies and Research, University of Regina, 2016-07-18) Arthur, Deena Gaye; Hampton, Mary; Malloy, David; Novik, Nuelle; Clune, Laurie
Menopause is a private, physiological change event that begins with the body but is greatly influenced by social context. While the current knowledge base about the experience is extensive it is also fragmented and incomplete. The primary focus is on symptoms and the loss of estrogen with women’s direct experience of menopause largely missing from the public discourse. This study proposes a model of menopause that unifies the disparate viewpoints through understanding postmenopausal women’s lived experience. The study design is based on the grounded theory qualitative research methodology of B.G. Glaser and A.L Strauss (1967), Kathy Charmaz (2012, 2014), and Karin Olson (2011). The methods are informed by the feminist theory of Judith Wuest (1995, 2001). A collaborative and creative research setting supported informal conversations with 10 Canadian, postmenoapusal women aged 58 to 78. The women participated in artbased, self-reflection exercises using buttons and a variety of physical objects. Transcribed conversations were analyzed using the grounded theory constant comparison technique. Outcomes include personal narratives, photographs of created art objects, and a proposed model of menopause. The proposed model can be used by women to prepare for and live through the menopausal transition and could be developed into a substantive theory of menopause. The key concept is personal agency and the three main constituent factors: awareness of self worth, strong finances, and good health. Personal agency is key to postmenopausal life satisfaction. Women concerned with maintaining quality of life could focus on strengthening personal agency rather than over focusing on menopausal symptoms.