Canadian Journal of Nursing Research最新文献

{"title":"Pressed for Time: Physiological Indicators of Care Aides' Mental Workload in Response to Simulated Pressures in Long-Term Care Homes.","authors":"Jennifer Moore, Patricia Morris, Rose McCloskey, Karen Furlong, Sue McNulty","doi":"10.1177/08445621251385021","DOIUrl":"10.1177/08445621251385021","url":null,"abstract":"<p><p>BackgroundMental workload is an important indicator of an individual's interaction with task demands. Care aides in long-term care (LTC) settings frequently report excessive demands imposed on their daily work due to challenging resident behaviours and organizational expectations. Understanding mental workload in these contexts is key to predicting staff strain and guiding support strategies.MethodsTwenty-eight care aides from six LTC homes in New Brunswick, Canada, participated in a simulated care scenario involving common challenges encountered when completing resident care. Two physiological markers of mental workload, namely heart rate variability (HRV) and pupil dilation, were continuously measured across five experimental stages, each designed to elicit different cognitive and emotional demands. Hierarchical mixed-effects models assessed the impact of demographic variables and experimental stages on mental workload.ResultsMental workload increased significantly, as indicated by decreased HRV and increased pupil diameter, when the care aide was required navigate impossible requests made by the resident. Contrary to expectations, resistance to care, verbal aggression, direct time pressure, and intervention by a supervisor did not significantly influence physiological correlates of mental workload.ConclusionThese findings suggest that creative problem-solving, such as responding to impossible resident demands, may be more mentally taxing than expected stressors like aggression or time pressure. To manage mental workload, staff should be prepared and supported to adapt creatively under pressure. Further efforts should be made to understand the relationship between increased mental workload and cumulative stress in care aides.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"221-233"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse Practitioners' Experiences Navigating Treatment Decision-Making Affecting Older People with Neurocognitive Disorders and Cancer.","authors":"Kimberly Shapkin, Lorelei Newton, Karen MacKinnon, Jayna Holroyd-Leduc","doi":"10.1177/08445621251412229","DOIUrl":"10.1177/08445621251412229","url":null,"abstract":"<p><p>Background and PurposeNurse practitioners (NPs) make treatment decisions impacting older people with neurocognitive disorders (NCDs), like mild cognitive impairment and dementia. Research has shown that when this patient population has cancer, they face barriers accessing care, have higher mortality rates and limited involvement in decision-making. Despite their critical role, few NPs have been included in studies exploring treatment decision-making affecting this population. To improve experiences for older people and their families, this study explored NPs' decision-making experiences when individuals were living with an NCD and cancer.MethodsThis qualitative study was informed by interpretive description, a practice-oriented approach. Data collection methods included semi-structured interviews and reflective journaling. Data analysis was iterative with identification and revision of themes that have accompanying illustrations. The research team drew on relevant nursing and practice knowledge to identify meaningful implications for NP practice.ResultsFive themes were identified which included the observation that participants' decision-making was shaped by NPs' knowledge and assumptions. NP participants experienced uncertainty and ethical challenges while needing to creatively navigate health systems. Drawing on nursing knowledge, NPs sought to actively involve older people and their family in decision making.ConclusionNPs experience complex treatment decision-making when older people are living with an NCD and cancer, requiring navigation of multiple factors and challenges. The results showed shared decision-making processes are applied, suggesting that NPs take up relational treatment decision-making practices. However, there is a need for institutional change, further education, and research about NPs experiences in community settings.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"168-182"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"We Don't Want to Cry Wolf\": A Qualitative Study About Nurses' Experiences Activating Rapid Response Teams.","authors":"Lindsay Fitzgerald, Kim Sears, Rosemary Wilson, Lenora Duhn","doi":"10.1177/08445621251400541","DOIUrl":"10.1177/08445621251400541","url":null,"abstract":"<p><p>Background & PurposePatient clinical deterioration is a major safety concern. One strategy implemented for health providers to improve the timely recognition and response to patient deterioration is the Rapid Response Team (RRT). Despite this resource, patient deterioration still occurs and delayed activation of the RRT is one contributing factor. Little is known about unit-level nurses' experiences related to RRT activation, especially within the Canadian context, which is problematic given they are the ones who are primarily responsible for initiating the process. The purpose of this study was to understand the experiences of nurses practising on general adult inpatient medicine units and their activation of the RRT.Methods & ProceduresThe research question was addressed with a descriptive, exploratory qualitative study. Nurses working on general adult inpatient medicine units at an Ontario hospital study site were purposively recruited to participate. Semi-structured interviews with the six participants were held online and audio-video recorded. Inductive, thematic analysis was used.ResultsEleven themes about the barriers and facilitators to RRT activation, and one overarching theme-the <i>Self-Imposed Complexity of Deciding to Activate the RRT-</i>resulted in relation to the nuanced, multi-factorial decision-making process unit-level nurses undertake when considering activation.ConclusionThis study contributes novel information to better understand RRT activation by nurses and will inform practice changes surrounding RRT policies, nursing education about the RRT, and new research on optimizing strategies for RRTs and deteriorating patients. The multi-layered activation process intricacies positions future work to improve escalation of patient clinical deterioration.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"114-128"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of an Online Patient Portal on Nurses' and the Health Care Team's Work in an Outpatient Oncology Setting: A Qualitative Study.","authors":"Sarah Jane Quinn, Vera Caine, Olga Petrovskaya","doi":"10.1177/08445621251396991","DOIUrl":"10.1177/08445621251396991","url":null,"abstract":"<p><p>BackgroundIn November 2022, Alberta Health Services launched a new province-wide electronic health record, Connect Care (Epic), with a tethered patient portal, MyAHS Connect, across all Cancer Care Alberta sites. Oncology patients now can view their health record (including results), view and manage appointments, enter data directly into their chart, and securely message their health care team.PurposeTo explore how an online patient portal effects nurses and the health care team's work in an outpatient oncology setting.MethodsA descriptive qualitative method was used for this research study. 15 health care providers were recruited (12 registered nurses, 2 medical oncologists, 1 clerical worker). Data was analyzed using thematic analysis with a technology-in-practice sociomaterial theoretical perspective informing our approach.ResultsThree main themes were generated: the invisibility of nurses' responsibility of supporting patient portal use, access to the portal shapes a new type of patient, and MyAHS Connect is as good as the networks of care provision in which it is embedded.ConclusionThis qualitative study details how patient access to the portal changed the ways that health care providers are working but the degree of this change was highly influenced by patient use of the portal, staff's use of the electronic health record, and the greater system context. This research highlights the substantial role of nurses when patient portals are used in health care practice settings.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"101-113"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centring Social Justice in Nursing Educational Resources: Equity, Diversity, and Inclusion.","authors":"Jennifer L Lapum, Oona St-Amant, Michelle Hughes, Joy Garmaise-Yee","doi":"10.1177/08445621251415254","DOIUrl":"10.1177/08445621251415254","url":null,"abstract":"<p><p>Background and purposeOpen educational resources (OER) are socially progressive learning resources that are well positioned to disrupt the exclusionary and marginalizing processes that can sometimes occur within nursing texts. Recognizing the social justice underpinnings of OER, the study focus was to examine how leadership teams should integrate equity, diversity, and inclusion (EDI) into the design and production of nursing-related OER.Methods and proceduresThis study was theoretically informed by the concept of Othering. The interpretive descriptive methodology involved reflexive and critical dialogue with focus group data that honed skeptical thinking and encouraged the search for alternative ways to think about how codes and themes were named and conceptualized.FindingsParticipating in the two hour focus group were nine leaders, who were authors of two nursing-related OER. Participants included six nurse educators, one educational developer, and two students. Three themes were identified including: diversifying design and production; centring social justice; and nuancing inclusion.Discussion and conclusionPart of the blueprint to the design and production of OER that are shaped by EDI must include incredibly rich, vibrant, and diverse voices and teams who are focused on social justice. This approach offers ways to create space for the beauty of human difference, the nuances of inclusion, and the flourishing and growth of learners. Although we may never produce resources that fully embrace inclusion and belonging, we are confident that diverse and critical voices will shift us closer while centring social justice.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"156-167"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Descriptive Comparison of Scoring Methods and Criteria for Evaluating Consensus in Modified Delphi Methods.","authors":"Marlo Salum, Kara Schick-Makaroff, Richard Sawatzky","doi":"10.1177/08445621251414530","DOIUrl":"10.1177/08445621251414530","url":null,"abstract":"<p><p>Background and PurposeModified Delphi methods are increasingly used to develop healthcare pathways with input from people with lived experience (PWLE) and clinicians/others. However, guidance on consensus analysis in this context remains limited. We examined consensus outcomes across different scoring methods and criteria when participants were treated as a single combined group (<i>Objective 1</i>) versus two distinct groups (<i>Objective 2</i>).MethodsWe conducted a secondary analysis of Round 1 data from a project involving PWLE (N = 8) and clinicians/others (N = 51). To assess agreement on 68 Delphi statements, we applied three methods for scoring percentage agreement that differed in how the middle response on a three-point Likert scale (\"approve\", \"not sure either way\", \"do not approve\") was treated. Method 1 excluded the middle response, methods 2 and 3 grouped the middle response with \"do not approve\", and \"approve\", respectively. We compared consensus rates (% of items reaching consensus) using percentage agreement cutoffs of ≥70%, ≥80%, and ≥90% of participants.ResultsConsensus results varied by participants grouping, treatment of middle response categories, and cutoff criteria. Results from the combined group of PWLE and clinicians/others provided a simplified overview consensus outcome. Treating the participants into as separate groups provide nuanced results.ConclusionThe analysis of data can change the results from which to draw conclusions and inform practice. Investigators should consider the alignment of each approach with the goals of their Delphi study.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"234-246"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parish Nursing: A Novel and Easy Access to Territorial Care for Patients' Management and Primary Care Empowerment in Italy.","authors":"Flavia Masini, Angela Coco, Donatella Sarti, Stefano Ridolfi, Tamara Campanelli, Emilia Prospero, Andrea Minelli","doi":"10.1177/08445621261417093","DOIUrl":"10.1177/08445621261417093","url":null,"abstract":"<p><p>Background and purposeAccess to healthcare remains difficult for many, particularly in underserved areas. In Italy's Marche Region, parish nursing agencies have been introduced as a territorial care strategy for enhancing access to healthcare and strengthening community-based services. The aim of this study is to assess the socio-demographic characteristics, service utilization, and satisfaction of users attending a parish nursing agency in the Marche Region.Methods and proceduresThis quantitative, cross-sectional explorative study drew on original data collected through an anonymous questionnaire completed by clients of a parish nursing agency. The responses were analyzed using descriptive statistical methods.Results82 individuals participated; 77% were autonomous, while 23% were accompanied by a caregiver. Among those without caregivers, 24% were foreigners, significantly higher than the regional average. Most users had a high educational level and at least one chronic condition. Frequently requested services included medical appointment scheduling, vital sign monitoring, and health information. Satisfaction was high: 83% rated the service as \"excellent\", and 17% as \"satisfying\".ConclusionThese preliminary findings indicate that parish nursing can provide accessible, person-centered, and satisfactory care to vulnerable individuals from diverse educational and socioeconomic backgrounds and suggest that parish nursing agencies could be considered a valuable component in shaping health policy recommendations.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"199-206"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers Encountered by Migrant Farm Workers When Accessing Health Care Services in Canada: A Scoping Review.","authors":"Sharona Naidoo, Sherry Morrell, Jamie Crawley, Gina Pittman, Adam Mulcaster, Kathryn Pfaff, Joanne Tay, Gauri Kumar, Kaitlynn Scott","doi":"10.1177/08445621251415252","DOIUrl":"10.1177/08445621251415252","url":null,"abstract":"<p><p>ObjectiveThis scoping review aims to examine and map existing literature about barriers encountered by migrant farm workers accessing health care services in Canada.MethodsThe search was conducted in multiple databases and grey literature. The PRISMA-ScR was used to document the inclusion and exclusion process. Two or more team members screened and reviewed all articles to ensure accuracy in capturing data.Synthesis380 records were screened by examining abstracts and titles, and 325 were deemed irrelevant. Of the remaining records, 55 had full-text assessments; 16 were excluded because they did not meet the inclusion criteria. Thirty-nine articles were extracted. They represented a mix of qualitative and quantitative studies, reviews, and other forms of commentaries and analyses. The thematic analysis revealed barriers that affect migrant farm workers' access to Canadian health care services: (1) language and literacy challenges, (2) concern of medical repatriation, (3) lack of transportation, (4) barriers to timely care and medical follow-up, (5) restrictive work schedules, and (6) health care coverage issues.ConclusionThis review provides a synthesis of the barriers experienced by migrant farm workers when accessing Canadian health care services. Canadian health care policy experts and organizations where Canadian migrant farm workers seek care are encouraged to design and implement policies, practice changes and/or educational interventions to address these barriers. This review may also inform public health nursing programming to promote positive health outcomes in the migrant farm worker population.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"247-257"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Afghan Refugees' Post-Resettlement Experiences in North America: A Scoping Review.","authors":"Hasina Amanzai, Betty Q Wang, Cristina Catallo, Sepali Guruge, Souraya Sidani, Bharati Sethi, Erin Ziegler, Stephanie Nishi, Pheba Joy, Angelina Stafford, Andrea Borges, Mushgan Sediq","doi":"10.1177/08445621261420300","DOIUrl":"10.1177/08445621261420300","url":null,"abstract":"<p><p>BackgroundDecades of war and political instability have forced millions of Afghans to flee from their homes, resulting in one of the world's largest humanitarian crises. Many refugees have resettled in North America, particularly in Canada and the United States, where they have encountered numerous psychosocial and systemic barriers to adapting to their new environment.ObjectiveThis scoping review aims to explore the settlement experiences of Afghan refugees in North America, synthesize existing evidence on integration challenges, and identify key gaps in the literature.MethodsFollowing Arksey and O'Malley's methodological framework, six electronic databases were searched for relevant literature published between 2014 and 2024, which focused on Afghan refugee settlement experiences in the North American context. Seventeen eligible studies were included in the final review.ResultsMental health emerged as the most studied topic, with Afghan refugees experiencing moderate to high rates of psychological distress, depression, and post-traumatic stress disorder. Key risk factors included female gender, older age, pre-migration trauma, financial constraints, and social isolation. Protective factors, such as, strong social support networks, English language proficiency, and gainful employment were associated with improved mental health outcomes. In spite of the generally positive healthcare experiences, Afghan refugees encountered language barriers, limited health literacy, transportation difficulties, and cultural misunderstandings with healthcare providers.ConclusionAfghan refugees in North America face complex and intersecting barriers to health and healthcare access, and integration. Current literature by and large focuses on mental health, and there is an urgent need to expand research in other important areas of post-migration and (re)settlement.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"258-275"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking Through the Glass Ceiling-Having <i>That</i> Conversation: A Constructivist Grounded Theory Study Exploring the Experiences of Nephrology Nurses' Practice in Kidney Supportive Care in Canada.","authors":"Jovina Concepcion Bachynski, Lenora Duhn, Idevania G Costa, Pilar Camargo-Plazas","doi":"10.1177/08445621251395378","DOIUrl":"10.1177/08445621251395378","url":null,"abstract":"<p><p>BackgroundDialysis as treatment for kidney failure can result in significant physical and psychosocial symptom burden. Kidney supportive care (KSC), encompassing advance care planning (ACP), is an approach to care involving early identification and treatment of symptoms that improves the quality of life of people receiving dialysis. However, ACP is underused and often initiated late in the illness. The delay or lack of engagement in KSC by nephrology nurses until near the end of life may result in people receiving care that is discordant with their values, wishes, and preferences.PurposeThe purpose of our study was to construct a substantive theory about the process of engagement in KSC by nurses in Canadian dialysis settings.MethodsUsing Charmaz's constructivist grounded theory method, 23 registered nurses working in hemodialysis and peritoneal dialysis were recruited to participate in two intensive interviews. Concurrent data collection and analysis were undertaken, with constant comparative analysis of codes until the attainment of theoretical saturation, as well as memo-writing and researcher reflexivity, to aid the emergence of categories and concepts.FindingsIn the substantive theory \"Breaking Through the Glass Ceiling of Engagement-Having <i>That</i> Conversation,\" three stages of engagement (Transactional, Intentional, Actional) are identified that describe nurses' practice patterns of engagement in communication about goals of care with patients. This engagement is modulated by a boundary of professionalism and familiarity with patients, amid multi-dimensional contextual barriers.ConclusionNephrology nurses have a vital role in discussions about goals of care and require training to enhance their communication skills.</p>","PeriodicalId":46661,"journal":{"name":"Canadian Journal of Nursing Research","volume":" ","pages":"141-155"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}