Facets of Parenting a Child with Hypoplastic Left Heart Syndrome

The purpose of the study was to conceptualize the needs of parents of young children with hypoplastic left heart syndrome (HLHS) to provide a theoretical framework to inform the development of future parent interventions. Participants were parents and grandparents (n = 53) of 15 young children who had undergone the Sano surgical approach for HLHS. Analysis of recorded and transcribed single interviews with each participant was done as directed by interpretive description methodology. A model of five facets of parenting was conceptualized. These included survival parenting, “hands-off” parenting, expert parenting, uncertain parenting, and supported parenting. The facets of parenting delineated through this study provide a theoretical framework that can be used to guide the development and evaluation of interventions for parents of children with complex congenital heart disease and potentially other life-threatening conditions. Each facet constitutes a critical component for educational or psychosocial intervention for parents

Expanding Qualitative Research Interviewing Strategies: Zoom Video Communications

The proliferation of new video conferencing tools offers unique data generation opportunities for qualitative researchers. While in-person interviews were the mainstay of data generation in qualitative studies, video conferencing programs, such as Zoom Video Communications Inc. (Zoom), provide researchers with a cost-effective and convenient alternative to in-person interviews. The uses and advantages of face-to-face interviewing are well documented; however, utilizing video conferencing as a method of data generation has not been well examined. The purpose of this paper is to examine the specific attributes of Zoom that contribute to high quality and in-depth qualitative interviews when in person interviewing is not feasible. While video conferencing was developed to facilitate long-distance or international communication, enhance collaborations and reduce travel costs for business these same features can be extended to qualitative research interviews. Overall, participants reported that Zoom video conferencing was a positive experience. They identified strengths of this approach such as: (1) convenience and ease of use, (2) enhanced personal interface to discuss personal topics (e.g., parenting), (3) accessibility (i.e., phone, tablet, and computer), (4) time-saving with no travel requirements to participate in the research and therefore more time available for their family. Video conferencing software economically supports research aimed at large numbers of participants and diverse and geographically dispersed populations

Professional Development Needs of Non-Radiology Nurses: An Exploration of Nurses’ Experiences Caring for Interventional Radiology Patients

Nursing in interventional radiology is diverse and multifaceted. This area of specialty nursing has not yet been acknowledged as such or embraced in Canada. Professional development for interventional radiology nurses is lacking with even fewer educational opportunities for non-radiology nurses who care for interventional radiology patients throughout the hospital to develop needed interventional radiology knowledge and related skills. This qualitative descriptive study explored the experiences non-radiology nurses have caring for interventional radiology patients. Interviews with ten non-radiology nurses in a Canadian hospital provided rich data for analysis. Thematic analysis revealed that these nurses did not receive formal IR education in their nursing curriculum, acquired their knowledge through self-teaching, lacked knowledge about imaging modalities and IR procedures, were impeded to build trusting nurse-patient relationships, and felt ineffective communication disrupted the continuity of care they provided. Addressing professional development needs related to creating interventional radiology education, increasing awareness of the specialty of interventional radiology nursing, and enhancing clinical collaboration is a key recommendation

A Canadian Study toward Changing Local Practice in the Diagnosis of Pediatric Celiac Disease

Background. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition endorses serological diagnosis (SD) for pediatric celiac disease (CD). The objective of this study was to pilot SD and to prospectively evaluate gastrointestinal permeability and mucosal inflammation at diagnosis and after one year on the gluten-free diet (GFD). We hypothesized that SD would be associated with similar short term outcomes as ED. Method. Children, 3-17 years of age, referred for possible CD were eligible for SD given aTTG level ≥200 U/mL, confirmed by repeat aTTG and HLA haplotypes. Gastrointestinal permeability, assessed using sugar probes, and inflammation, assessed using fecal calprotectin (FC), at baseline and after one year on a GFD were compared to patients who had ED. Results. Enrolled SD ( = 40) and ED ( = 48) patients had similar demographics. ED and SD groups were not different in baseline lactulose: mannitol ratio (L : M) (0.049 versus 0.034; = 0.07), fractional excretion of sucrose (%FES; 0.086 versus 0.092; = 0.44), or fecal calprotectin (FC; 89.6 versus 51.4; = 0.05). At follow-up, urine permeability improved and was similar between groups, L : M (0.022 versus 0.025; = 0.55) and %FES (0.040 versus 0.047; = 0.87) ( > 0.05). FC improved but remained higher in the SD group (37.1 versus 15.9; = 0.04). Conclusion. Patients on the GFD showed improved intestinal permeability and mucosal inflammation regardless of diagnostic strategy. This prospective study supports that children diagnosed by SD have resolving mucosal disease early after commencing a GFD

“Realizing the problem wasn’t necessarily me”: the meaning of childhood adversity and resilience in the lives of autistic adults

Purpose There is evidence that childhood adversity is correlated with poor health outcomes across the lifespan. Resilience results when internal and external protective factors in childhood mitigate this relationship. However, among children on the autism spectrum, these relationships are understudied, and little is known about the characteristics and role of adversity and resilience in their in their lives. This study interprets these phenomena as experienced by autistic young adults. Methods Initially, we conducted community engagement with five members of the autism community who advised on the research question, research design, and analysis. Subsequently, four autistic young adults, three women and one non-binary, aged 19–27, were recruited to participate in semi-structured interviews via phone, video conference, and online chat. Credibility checking interviews followed data analysis. Results Through interpretative phenomenological analysis we identified themes related to the negative effects of adversity, including social disconnection, mental and emotional well-being, sense of self, and development into young adulthood. Resilience developed in places of refuge and identity and was evident in their transitions into young adulthood. Conclusion These findings provide direction for decreasing adversity and fostering resilience in children and adolescents on the autism spectrum

Exploring beliefs around physical activity among older adults in rural Canada

Objective: As physical activity can improve health and reduce the risk of chronic disease, it is important to understand the contributing factors to physical activity engagement among older adults, particularly those living in rural communities to assist in remaining active and healthy as long as possible. The purpose of this study was to gain a deeper understanding of the socio-ecological factors that influence or contribute to physical activity among rural-dwelling older adults in rural Saskatchewan, Canada. Methods: This qualitative description explored the perceptions of physical activity among older adults living in two rural communities in the Canadian province of Saskatchewan. Semi-structured interviews were conducted with 10 adults aged 69–94. Using content analysis techniques, transcribed interview data were coded and categorized. Results: Participants identified socio-ecological elements facilitating physical activity such as improved health, independence, and mobility as well as social cohesion and having opportunities for physical activity. The most common perceived environmental barrier to engaging in physical activity was the fear of falling, particularly on the ice during the winter months. Participants also cited adverse weather conditions, aging (e.g., arthritis), and family members (e.g., encouraged to “take it easy”) as barriers to physical activity. Conclusion: Hearing directly from older adults who reside in rural Saskatchewan was determined to have the potential to improve awareness of physical activity in rural communities to support the implementation of programs and practices that will facilitate active lifestyles for older adults

A Canadian Study toward Changing Local Practice in the Diagnosis of Pediatric Celiac Disease

Background. The European Society for Pediatric Gastroenterology, Hepatology and Nutrition endorses serological diagnosis (SD) for pediatric celiac disease (CD). The objective of this study was to pilot SD and to prospectively evaluate gastrointestinal permeability and mucosal inflammation at diagnosis and after one year on the gluten-free diet (GFD). We hypothesized that SD would be associated with similar short term outcomes as ED. Method. Children, 3–17 years of age, referred for possible CD were eligible for SD given aTTG level ≥200 U/mL, confirmed by repeat aTTG and HLA haplotypes. Gastrointestinal permeability, assessed using sugar probes, and inflammation, assessed using fecal calprotectin (FC), at baseline and after one year on a GFD were compared to patients who had ED. Results. Enrolled SD (n=40) and ED (n=48) patients had similar demographics. ED and SD groups were not different in baseline lactulose: mannitol ratio (L : M) (0.049 versus 0.034; p=0.07), fractional excretion of sucrose (%FES; 0.086 versus 0.092; p=0.44), or fecal calprotectin (FC; 89.6 versus 51.4; p=0.05). At follow-up, urine permeability improved and was similar between groups, L : M (0.022 versus 0.025; p=0.55) and %FES (0.040 versus 0.047; p=0.87) (p>0.05). FC improved but remained higher in the SD group (37.1 versus 15.9; p=0.04). Conclusion. Patients on the GFD showed improved intestinal permeability and mucosal inflammation regardless of diagnostic strategy. This prospective study supports that children diagnosed by SD have resolving mucosal disease early after commencing a GFD