Faculty of Nursing

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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
Baby-friendly initiatives to promote, protect and support breastfeeding practices of immigrant mothers: A qualitative study in Saskatchewan, Canada
(Elsevier BV, 2023-03) Shela Akbar Ali Hirani
Immigrant mothers, who often experience separation from extended family and social disconnection in a new country, are at risk of experiencing reduced physical, mental and emotional well-being, especially during the perinatal phase of their lives. Saskatchewan has a noticeable increase in the immigrant population with young children, limited availability of healthcare settings with baby-friendly initiative (BFI) status, potential risks to the health of young immigrant children after breastfeeding discontinuation, and the limited number of empirical studies that intend to seek recommendations from immigrant mothers on need-based initiatives that can promote, protect and support their breastfeeding practices. This qualitative study intended to seek recommendations from immigrant mothers belonging to diverse ethnic groups on need-based initiatives to promote, protect and support the breastfeeding practices of immigrant mothers in Saskatchewan, Canada. Using a critical ethnographic study design, this study was undertaken in Saskatchewan, Canada. After receiving ethics approval, in-depth interviews were undertaken with 30 immigrant mothers with young children of age 1 day to 24 months. Immigrant mothers were recruited from different cities through purposive and snowball sampling. Data was also gathered through observations of breastfeeding services in Saskatchewan. Immigrant mothers recommended the need for support from people in their social network (healthcare provider, husband, community and government), baby-friendly initiatives in hospital and community-based settings (breastfeeding counselling facilities, breastfeeding education before and after childbirth, and follow-up care), culturally-sensitive care (interpretation services and culturally appropriate food in hospitals), breastfeeding helplines (offering services in multiple languages), breastfeeding acceptance in a variety of public places (workplace, airports, restaurants, parks and public transportation), and investment in immigrant programs (maternal and child programs) to promote the well-being of immigrant mothers with young children. Breastfeeding support in hospitals, public places, workplaces and society at large is essential to promote, protect and support the breastfeeding practices of immigrant mothers in Saskatchewan, Canada. The role of healthcare professionals, family members, workplace supervisors and colleagues, policymakers, and governmental/non-governmental organizations is crucial in supporting the breastfeeding practices of immigrant mothers.
Open Access
Breastfeeding Challenges of Immigrant Mothers during COVID-19
(Faculty of Nursing, 2022-05-21) Hirani, Shela
Globally, the COVID-19 pandemic has negatively affected the health and well-being of the population, especially immigrant women with young children. It is essential to explore the breastfeeding experiences of vulnerable immigrant women who often lack adequate breastfeeding support in a new country. This video presents the positive and negative effects of COVID-19 on breastfeeding practices of immigrant mothers in Saskatchewan, Canada
Open Access
Breastfeeding Challenges of Immigrant Women in the Workforce
(Faculty of Nursing, 2022-08-28) Hirani, Shela
This video presents the breastfeeding challenges of immigrant mothers who combine breastfeeding with employment.
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
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.
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
Caring for breastfeeding mothers in disaster relief camps: A call to innovation in nursing curriculum
(Elsevier BV, 2022-12) Shela Akbar Ali Hirani
During natural disasters, people are forced to flee their homes and resettle in temporary disaster relief camps (such as huts, tents, and transitional shelters) that are often located on barren ground, far from cities. Disaster relief camps are one of the most vulnerable settings where women are at risk of discontinuing their breastfeeding practices. A critical ethnographic study undertaken with the internally displaced mothers residing in disaster relief camps in Pakistan re- vealed that the availability of formal support from healthcare professionals is one of the key determinants that shape the breastfeeding experiences of the displaced mothers. Hence suggested the need for innovative strategies in the nurs- ing curriculum to build the capacity of nurses to provide culturally sensitive care to breastfeeding mothers affected by disaster and displacement. Considering these findings, it is recommended that nursing educational settings must in- clude courses on “caring for the vulnerable population during a disaster” at the baccalaureate, graduate, and post- graduate levels. The inclusion of these courses will foster nurses to understand the needs of the displaced community, identify the importance of making a difference through collaborative work, and take part in designing innovative interventions (surrounding health, housing, economic upliftment, and well-being) for the displaced communities. Moreover, onsite clinical experience in disaster relief camps is recommended. This will enhance nurses' competence, hands-on skills, knowledge, and cultural sensitivity while providing care to displaced mothers with a variety of clinical presentations and breastfeeding concerns. Continuing education sessions and seminars must be organized for nurses to update their knowledge about breastfeeding and facilitate evidence-based practice in the setting of disaster relief camps.
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
Challenges of Conducting a Critical Ethnographic Breastfeeding Study in the Post-Disaster Settings: Lessons Learned
(Bentham Science Publishers Ltd., 2023-01-09) Shela Akbar Ali Hirani
Post-disaster settings are the most vulnerable settings where researchers may face challenges specific to their safety, research logistics, and maintenance of ethical integrity in a high-stress context. This paper presents the researcher’s reflections on undertaking a critical ethnographic breastfeeding study in the post-disaster settings of rural Pakistan where displaced women with young children were under extreme stress due to recurrent natural disasters, displacement, disruption to life, and homelessness. This paper identifies encountered challenges by the researcher during fieldwork in that post-disaster settings, presents the strategies utilized by the researcher during the fieldwork, and shares recommendations for future researchers on ways to maintain research integrity in this challenging context.
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
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
Editorial: Conflicts and humanitarian crises on displaced people's health.
(Frontiers Media S.A., 2023-07-11) Hossain, Ahmed; Bartolucci, Andrea; Hirani, Shela Akbar Ali
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
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
Emerging health technologies: Ethical considerations in nursing practice and care [PowerPoint slides]
(University of Regina, 2023-03-15) Arries-Kleyenstuber, Ebin; Davies, Shauna
Open Access
Emerging health technologies: Ethical considerations in nursing practice and care [Webinar recording]
(University of Regina & Association québécoise des infirmières et infirmiers en systèmes et technologies de l’information (AQIISTI), 2023-03-15) Arries-Kleyenstuber, Ebin; Davies, Shauna
Open Access
Ethical challenges regarding emerging digital technologies in virtual nursing care and practice [Evidence brief]
(The Social Sciences and Humanities Research Council in collaboration with the Future Skills Centre, 2022-04) Arries-Kleyenstuber, Ebin; Davies, Shauna; Luhanga, Florence; Chipanshi, Mary; Cosford, Kristen; Azogu, Irene
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.

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