Faculty of Nursing

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Open Access
Effects of early life experiences on brain development of premature babies admitted in neonatal intensive care unit
(Savvy Science Publishers, 2013-04-04) Hirani, S. A.
Infancy is the most crucial time period in children’s life during which babies require sensitive and responsive care-giving from their primary caregivers for their overall growth and development. Sick preterm babies, who require admission at Neonatal Intensive Care Unit (NICU) and experience physical separation from their parents during early days of their lives, are at high risk to encounter toxic stress that can be detrimental for their developing brains, overall development and stress regulatory mechanism in later life. This paper presents case study of a preterm baby who encountered toxic stress due to the effects of disease process, physical separation from primary caregivers, painful procedures at NICU, as well as bright and noisy environment of NICU. In the light of the presented case study and reviewed literature, modifications in the NICU environment are suggested to reduce the sources of toxic stress on the developing brains of premature babies. Role of lactation support for mothers of preterm babies, kangaroo mother care, and neurodevelopmental care in the NICU environment is highlighted to assure growth promotion, brain development, infant-mother bonding, and better cognitive functions among premature babies.
Open Access
Conceptualizing an Expanded Role for RNs
(Open Journal of Nursing, 2014-02) Donnelly, Glenn; Domm, Liz
In our changing health care system, the role of registered nurses (RNs) has become indistinguishable from other nursing and health care providers’ roles. The purpose of this research was to explore the perspectives of nurse leaders and direct care RNs about the existing and future RN scope of practice. This research used an interpretive description analysis on data that was garnered from nurse leaders and RNs through separate focus groups. Participants identified existing threats to their roles, examined their scope of practice and proposed changes to the RN scope of practice. Specific areas that were identified included leadership, advocacy and expansion of RNs practices were dominant themes.
Open Access
Workplace Lactation Support Program: An Avenue to Benefit Workplace Settings, Employed Women and Infants
(MedCrave Group Kft., 2015-07-02) Shela Akbar Ali Hirani
Employed women are one of those groups who often find it challenging to continue their breastfeeding practices with paid work; hence they often up into stress and role- conflict due to their inability to manage infant’s feeding responsibilities along with employment. Considering the rising trend of women’s labor force participation and gradual decline in breastfeeding prevalence among employed women, in this paper, workplace lactation support program is discussed as an avenue that can not only sustain breastfeeding practices of employed women and improve maternal and child health in a society but can also benefit workplace organizations by enhancing job satisfaction, decreasing absenteeism and lowering turnover rates among female employees.
Open Access
Factors contributing to practitioner choice when declining involvement in legally available care: A scoping protocol
(BMJ, 2018-07-27) Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Chipanshi, Mary
As legislation addressing medical treatments continues to evolve, there are several circumstances (eg, abortion, assisted dying) in which health practitioners may choose to not provide legally available care options. It is not always clear what underlies practitioner choice, as some research has suggested non-participation in care provision is not always due to an ethical abstention but may represent other factors. This results in tension between a practitioner’s right to refrain from practices deemed morally objectionable by the practitioner, and the care recipient’s right to access legally available treatments. The aim of this systematic scoping review is to identify the current knowledge regarding all the factors influencing practitioner’s choices when declining involvement in legally available healthcare options.
Open Access
Completion of Medical Certificates of Death after an Assisted Death: An Environmental Scan of Practices
(Longwoods, 2018-11) Brown, Janine; Thorpe, Lilian; Goodridge, Donna
Policies and practices have been developed to operationalize assisted dying processes in Canada. This project utilized an environmental scan to determine the spectrum of assisted death reporting practices and medical certificate of death (MCD) completion procedures both nationally and internationally. Findings suggest medically assisted dying (MAiD) is represented on the MCD inconsistently nationally and internationally. Related factors include the specifics of local assisted death legislation and variations in death-reporting legislation, variation in terminology surrounding assisted death and designated oversight agency for assisted dying reporting.
Open Access
Medical Assistance in Dying: Patients', Families', and Health Care Providers' Perspectives on Access and Care Delivery
(Mary Ann Liebert, 2020) Brown, Janine; Goodridge, Donna; Harrison, Averi; Kemp, Jordan; Thorpe, Lilian; Weiler, Robert
Open Access
Anxiety, mental illness, learning disabilities, and learning accommodation use: A cross-sectional study
(Elsevier, 2020) Brown, Janine; McDonald, Meghan; Besse, Cheryl; Manson, Patti; McDonald, Reid; Rohatinsky, Noelle; Singh, Madeline
Open Access
Care considerations in a patient-and family-centered medical assistance in dying program
(SAGE Publications, 2020) Brown, Janine; Goodridge, Donna; Harrison, Averi; Kemp, Jordan; Thorpe, Lilian; Weiler, Robert
Medical Assistance in Dying (MAID) became legal in Canada in June 2016. As part of a project designed to improve end-of-life care for those requesting MAID, qualitative data from patients, families, and providers were used to assess opportunities to enhance patient-and family-centered care (PFCC) in this program.
Open Access
Breastfeeding During Covid-19 An Information Guide
(Faculty of Nursing, University of Regina, 2020-05-03) Hirani, Shela
Breastmilk is essential for the growth and development of young children. Considering its benefits, breastfeeding is recommended at all times for young children, especially during crisis situations such as the COVID-19 pandemic. This animated video on "Breastfeeding during COVID-19" provides need-based information to breastfeeding mothers who may lack breastfeeding support and access to information during the current state of emergency and self-isolation. It will also clarify misconceptions surrounding breastfeeding during COVID-19 and raise public awareness on safe infant feeding practices during this pandemic.
Open Access
Medical Assistance in Dying in health sciences curricula: A qualitative exploratory study
(Canadian Medical Education Journal, 2020-09-03) Brown, Janine; Goodridge, Donna; Thorpe, Lilian
This paper offers insight into (1) the driving and restraining forces impacting the inclusion of medical assistance in dying (MAID) in health sciences curricula, (2) the required resources for teaching MAID, and (3) the current placement of MAID in health sciences curricula in relation to end-of-life care concepts.
Open Access
Health & Well-being of Refugee Mothers during COVID-19
(Faculty of Nursing, University of Regina, 2021-02-03) Hirani, Shela
This resource is designed for Refugee Mothers in Saskatchewan, Canada to promote their health and well-being during COVID-19. Dr Shela Hirani and her team acknowledge the support of Jim Pattison Children’s Hospital Foundation that funded the Refugee Study in Saskatchewan.
Open Access
“What is right for me, is not necessarily right for you”: The endogenous factors influencing non-participation in medical assistance in dying
(SAGE Publications, 2021-05-03) Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Crizzle, Alexander
Access to medical assistance in dying (MAID) is influenced by legislation, health care providers (HCPs), the number of patient requests, and the patients’ locations. This research explored the factors that influenced HCPs’ nonparticipation in formal MAID processes and their needs to support this emerging practice area. Using an interpretive description methodology, we interviewed 17 physicians and 18 nurse practitioners who identified as non-participators in formal MAID processes. Nonparticipation was influenced by their (a) previous personal and professional experiences, (b) comfort with death, (c) conceptualization of duty, (d) preferred end-of-life care approaches, (e) faith or spirituality beliefs, (f) self-accountability, (g) consideration of emotional labor, and (h) future emotional impact. They identified a need for clear care pathways and safe passage. Two separate yet overlapping concepts were identified, conscientious objection to and nonparticipation in MAID, and we discussed options to support the social contract of care between HCPs and patients.
Open Access
Health & Well-Being of Refugee Mothers During COVID-19 Arabic Version (Saskatchewan, Canada)
(Faculty of Nursing, University of Regina, 2021-06-02) Hirani, Shela
The Arabic version of resource is designed for Refugee Mothers in Saskatchewan, Canada to promote their health and well-being during COVID-19. Dr. Shela Hirani and her team acknowledged the support of Jim Pattison Children's Hospital Foundation that supported their breastfeeding refugee study in Saskatchewan, Canada.
Open Access
“I Am Okay With It, But I Am Not Going to Do It”: The Exogenous Factors Influencing Non-Participation in Medical Assistance in Dying
(SAGE Publications, 2021-07-08) Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Crizzle, Alexander
Access to medical assistance in dying (MAID) is influenced by legislation, health care providers (HCPs), the number of patient requests, and the patients’ locations. This research explored the factors that influenced HCPs’ nonparticipation in formal MAID processes and their needs to support this emerging practice area. Using an interpretive description methodology, we interviewed 17 physicians and 18 nurse practitioners who identified as non-participators in formal MAID processes. Nonparticipation was influenced by their (a) previous personal and professional experiences, (b) comfort with death, (c) conceptualization of duty, (d) preferred end-of-life care approaches, (e) faith or spirituality beliefs, (f) self-accountability, (g) consideration of emotional labor, and (h) future emotional impact. They identified a need for clear care pathways and safe passage. Two separate yet overlapping concepts were identified, conscientious objection to and nonparticipation in MAID, and we discussed options to support the social contract of care between HCPs and patients.
Open Access
Emerging Digital Technologies in Virtual Care in Clinical Nursing Practice: An Integrative Review of Ethical Considerations and Strategies
(2021-08-04) Arries-Kleyenstuber, Ebin
Background. Leveraging the potential practical benefits of emerging digital technologies (EDTs) like robots, artificial intelligence, virtual reality, and 3D printing to provide and improve nursing care outcomes in ethical, sustainable ways requires an understanding of the ethical considerations regarding EDTs in clinical practice to inform research, practice, and policy. Objectives. To map and discuss the nature and scope of ethical considerations regarding EDTs in clinical nursing practice from published literature, and identify ethical approaches and strategies deemed effective to address such challenges. Results. Three main categories of ethical considerations that comprised 12 key emerging themes of ethical concerns were identified: Ethical Concerns related to Meaningful Understandings in the local Moral Horizon of Significance in Nursing Practice; the Organizational Imaginary; and Societal Imaginary. The twelve identified emerging key themes of ethical concerns regarding EDTs in clinical nursing practice comprised: (i) the nurse-patient relationship and inauthentic care interaction; (ii) patient dignity, autonomy and [self]deception; (iii) privacy, confidentiality, trust and integrity; (iv) patient safety; and (v) [social] justice, bias, discrimination, and stigmatization; (vi) Informed Consent, Transparency, and Data management; (vii) [Dis]Trust in the Healthcare System; (viii) Job displacement, Losses, and Fading in Professional Competencies; (ix) Liability, Accountability, Interpretability (Explainability); (x) Social isolation and Depersonalization of Human-beings and Care; (xi) Surveillance: Disciplining, Exploitation, and Manipulation of Human-beings and Society; and (xii) Vulnerability and Moral Fading: Human, Moral Authority and Agency and Future. Key messages. Emerging digital technologies offering promising benefits to help address disparities in care and improve the effectiveness of services. However, this requires a keen understanding of the nature and scope of ethical considerations with using emerging digital technologies such as robots, artificial intelligence, virtual reality, and three-dimensional (3D)-printing in clinical nursing practice. Understanding the identified ethical concerns and best-practice ethical strategies regarding EDT may help guide robust research, practice, and policy initiatives to generate, validate, and translate evidence on EDTs before use in virtual care. Moreover, evidence might be helpful to ensure the ethical design, applications, implementation, and evaluation of emerging digital tools and techniques for use in virtual nursing care in clinical practice to benefit and improve the health of vulnerable clients, nurses, and health systems in ethical and sustainable ways. Additionally, key ethical considerations regarding EDTs might be also help inform curriculum innovations to build capacity, cultivate ethical competency and responsiveness among nurses and other health professionals transitioning to a workplace amid digital ethics and technological disruptions to sustain good care and practice. Methodology. We conducted an integrative review using a comprehensive three-step sequential search strategy to search and retrieve published English language, peer-reviewed articles and grey literature documents from databases like CINAHL, PubMed, Web of Science, and Philosopher’s Index and relevant, reputable platforms. For this review, our team used COVIDENCE (Extraction 2.0 version) as a gold standard process and workflow platform to streamline our title and abstract screening, conduct a full-text review, data extraction, quality appraisal, data abstraction, evidence synthesis and interpretation to create high-quality systematic reviews. Following the removal of duplicate articles, the remaining articles were screened for eligibility using a two-step process: (i) title and abstract screening and (ii) full-text review against a set of inclusion and exclusion criteria. All included articles were read thoroughly to gain an understanding of the material. Following the title and abstract screening and full-text review process, a final sample of (n = 64) documents were selected that met all our inclusion criteria. We used an electronic data extraction form and a combination of quality appraisal tools from the Johanna Briggs Institute and the Centre for Children’s Health Ethics and Law (CCHEL) to extract essential methodological information and appraise the evidence from sampled documents. We used a five-stage Framework Analysis approach to abstract and synthesized evidence. This analysis provided a schematic diagram of ethical considerations related to using EDTs in virtual care, thus guiding the final interpretation of the data set while remaining mindful of the objectives of this review. The results of the review are presented both narratively and in a tabular format. A detailed discussion of ethical concerns and best-practice strategies, along with implications for health policy, education, clinical practice, and future research, is presented.
Open Access
Factors influencing practitioners’ who do not participate in ethically complex, legally available care: scoping review
(BioMed Central (BMC), 2021-09-28) Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Hodson, Alexandra; Chipanshi, Mary
Evolving medical technology, advancing biomedical and drug research, and changing laws and legislation impact patients’ healthcare options and influence healthcare practitioners’ (HCPs’) practices. Conscientious objection policy confusion and variability can arise as it may occasionally be unclear what underpins non-participation. Our objective was to identify, analyze, and synthesize the factors that influenced HCPs who did not participate in ethically complex, legally available healthcare.
Open Access
Challenges and Breastfeeding Experiences of Refugee Mothers in Saskatchewan, Canada
(Faculty of Nursing, University of Regina, 2021-11-02) Hirani, Shela
Refugee mothers are vulnerable to cultural stereotyping and socioeconomic hardships when they migrate to a new country. This vulnerability often has a negative impact on refugee mothers’ breastfeeding practices, related to social, emotional, psychological, and physical stressors. This video presents challenges and breastfeeding experiences of refugee mothers accessing and utilizing healthcare services in Saskatchewan, Canada.
Open Access
Challenges and Breastfeeding Experiences of Refugee Mothers in Saskatchewan, Canada - Arabic Version
(Faculty of Nursing, University of Regina, 2021-11-05) Hirani, Shela
Refugee mothers are vulnerable to cultural stereotyping and socioeconomic hardships when they migrate to a new country. This vulnerability often has a negative impact on refugee mothers’ breastfeeding practices, related to social, emotional, psychological, and physical stressors. This video presents challenges and breastfeeding experiences of refugee mothers accessing and utilizing healthcare services in Saskatchewan, Canada.
Open Access
Impact of COVID-19 on Women Who Are Refugees and Mothering: A Critical Ethnographic Study
(SAGE Publications, 2022-01) Shela Akbar Ali Hirani; Joan Wagner
Refugee women often experience trauma and social disconnection in a new country and are at risk of experiencing reduced physical, mental, and emotional well-being. Globally, COVID-19 has affected the health and well-being of the population at large. This critical ethnographic study aimed to explore the effects of COVID-19 on women who are refugees and mothering in Saskatchewan, Canada. In-depth interviews were undertaken with 27 women who are refugees and mothering young children aged 2 years and under. This study suggests that during COVID-19, refugee women are at high risk of experiencing add-on stressors due to isolation, difficulty in accessing health care, COVID-19-related restrictions in hospitals, limited follow-up care, limited social support, financial difficulties, and compromised nutrition. During COVID-19, collaborative efforts by nurses, other health-care professionals, and governmental and non-governmental organizations are essential to provide need-based mental health support, skills-building programs, nutritional counseling, and follow-up care to this vulnerable group.
Open Access
Breastfeeding Experiences and Recommendations of Immigrant Mothers in Saskatchewan
(Faculty of Nursing, University of Regina, 2022-01-26) Hirani, Shela
Immigrant mothers often lack adequate social support and access to health care services with breastfeeding supports that are affordable, accessible, need-based and culturally/gender-sensitive. This video presents breastfeeding challenges and recommendations of immigrant mothers in Saskatchewan, Canada on ways to promote, protect and support their breastfeeding practices.

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