Coping with Stressors by Drawing on Social Supports: The Experiences of Adolescent Syrian Refugees in Canada

This study explores how teenage Syrian refugees use their social networks to cope with stressors. Through interviews with nine youth aged 16 to 18 living in Ontario, Canada, stressors related to pre- and post-migration emerged. Family, peers, school staff, and organizations were identified as social networks, each having unique reasons why they were selected. Coping was categorized as individualistic or collectivistic. Teenage Syrian refugees draw upon social resources to navigate situations they are faced with, and cultural values influence the stress and coping process. Findings have implications for mental health care providers and policy-makers focused on migrant resettlement.Cette étude explore la manière dont les adolescents réfugiés syriens utilisent leurs réseaux sociaux afin de faire face aux facteurs de stress. À partir d’entrevues menées auprès de neuf jeunes âgés de 16 à 18 ans en Ontario, Canada, des facteurs de stress et post-migratoires ont émergé. La famille, les pairs, le personnel scolaire et les organisations ont été identifiés comme des réseaux sociaux, chacun ayant des raisons uniques pour lesquelles ils ont été sélectionnés. L’adaptation a été catégorisée comme individualiste ou collectiviste. Les adolescents réfugiés syriens s’appuient sur des ressources sociales pour traverser les situations auxquelles ils font face, et les valeurs culturelles ont une influence sur le stress et le processus d’adaptation. Les résultats ont des implications pour les prestataires de soins en santé mentale et les décideurs qui se penchent sur la réinstallation des migrants

Qualitative Health Research Involving Indigenous Peoples: Culturally Appropriate Data Collection Methods

Historically, health research involving Indigenous peoples has been fraught with problems, including researchers not addressing Indigenous research priorities and then subsequently often failing to utilize culturally appropriate methods. Given this historical precedence, some Indigenous populations may be reluctant to participate in research projects. In response to these concerns, the Government of Canada has developed the Tri-Council Policy Statement (TCPS2): Research Involving the First Nations, Inuit and Métis Peoples of Canada, which stipulates the requirements for research collaborations with Indigenous communities. Utilizing this policy as an ethical standard for research practices, this paper describes, critiques and synthesizes the literature on culturally appropriate oral-data collection methods, excluding interviews and focus groups, for use with Indigenous people in Canada. Results suggest that photovoice, symbol-based reflection, circles and story-telling can be methodologically rigorous and culturally appropriate methods of collecting data with this population. Suggestions are made for researchers wishing to use these methods to promote respectful and collaborative research partnerships with Indigenous peoples in Canada

Lessons Learned from Historical Analysis of Seven Decades of Educational Scholarship at McMaster University School of Nursing

The McMaster School of Nursing (SON) was approaching its 70th anniversary prompting a time of reflection on its contributions to nursing education. Were there lessons learned from the past that could provide a compass to navigate current day challenges and orient future strategies in the continued pursuit of excellence in nursing education? While the history of nursing education in Canada has been previously documented, there has been limited research into the evolution of different educational approaches. We decided to conduct in-depth historical analysis of the conditions that fostered educational scholarship and practice at our SON from 1946 to 2016. Using Danto’s (2009) descriptive historiography approach, we first compiled a chronological catalogue of evidences of educational scholarship and of major events that occurred within the SON through literature and archival document searches and 23 key informant interviews. We included a cultural historiography lens that uses a cultural framework to help explain influences on and of the SON activities. Several key areas of educational innovation and scholarship that have influenced nursing education nationally and internationally were identified. However, this article focuses on the historical development of three highly interrelated educational approaches in which the McMaster SON was an early leader: problem-based learning, evidence based nursing, and academic/community partnerships. The article further traces the influences on and of these approaches, set within the context of major events of the SON. Several lessons were uncovered by this historical analysis including building on existing strengths while being open to opportunities, being cognizant of the impact of organizational culture over time, using a proactive planning approach, and exploiting the exponential effect of innovations. A cautionary lesson on nursing’s voice in promoting our own knowledge was also uncovered. Applying the historical methodology taught us lessons on the preservation of nursing-specific information. This historical analysis of one school of nursing’s educational scholarship has provided insights in terms of understanding the forces that have shaped its educational approaches and how this history orients the thinking on educational changes proposed in response to ongoing challenges. Résumé À l’approche de son 70e anniversaire, l’école de sciences infirmières McMaster a pris un temps de réflexion par rapport à ses contributions à la formation en sciences infirmières. Des leçons apprises dans le passé pourraient-elles servir de guide pour gérer les défis d’aujourd’hui et orienter les futures stratégies dans la poursuite continue de l’excellence de la formation en sciences infirmières? Bien que l’histoire de la formation en sciences infirmières au Canada ait été documentée par le passé, il y a eu peu de recherche sur l’évolution des différentes approches pédagogiques. Nous avons décidé de réaliser une analyse historique en profondeur des conditions qui ont favorisé l’avancement des connaissances et la pratique à notre école de sciences infirmières de 1946 à 2016. En nous basant sur l’approche d’historiographie descriptive de Danto (2009), nous avons d’abord compilé un catalogue chronologique de faits sur les programmes pédagogiques et des évènements marquants qui ont eu lieu au sein de l’école de sciences infirmières par le biais de recherches dans la littérature et les archives et d’entrevues avec 23 informateurs clés. Nous avons inclus le point de vue de l’historiographie culturelle, qui utilise un cadre culturel pour aider à expliquer les influences sur et de l’école de sciences infirmières. Plusieurs domaines clés de l’innovation et des programmes pédagogiques qui ont influencé la formation en sciences infirmières au pays et ailleurs dans le monde ont été identifiés. Toutefois, cet article se concentre sur le développement historique de trois approches pédagogiques fortement reliées pour lesquelles l’école de sciences infirmières de McMaster était un chef de file précoce : l’apprentissage basé sur les problèmes, les sciences infirmières fondées sur des données probantes et les partenariats entre les universités et les communautés. L’article retrace également les influences de ces approches dans le contexte des évènements marquants de l’école. Plusieurs leçons ont été apprises grâce à cette analyse historique, notamment de compter sur des forces existantes tout en étant ouverts aux opportunités, reconnaître l’impact de la culture organisationnelle au fil du temps, utiliser une approche de planification proactive et exploiter les effets exponentiels de l’innovation. Une mise en garde a également été établie sur la voix des sciences infirmières pour promouvoir nos propres connaissances. L’application de la méthodologie historique nous a appris des leçons sur la conservation d’informations spécifiques aux sciences infirmières et l’analyse historique de la formation et l’avancement des connaissances d’une école de sciences infirmières a donné un aperçu des forces qui ont forgé ses approches pédagogiques et la façon dont l’histoire guide la réflexion sur les changements pédagogiques proposés en réponse aux défis perpétuels

Mothers\u27 Experiences in the Nurse-Family Partnership Program: A Qualitative Case Study

BACKGROUND:Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers\u27 experiences participating in the Nurse-Family Partnership (NFP) Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant\u27s first birthday.METHODS:A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently.RESULTS:The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent.CONCLUSIONS:Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers\u27 perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers\u27 unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation

Be Healthy in Pregnancy: Exploring factors that impact pregnant women\u27s nutrition and exercise behaviours

Excess gestational weight gain is associated with short- and long-term pregnancy complications. Although a healthy diet and physical activity during pregnancy are recommended and shown to reduce the risk of complications and improve outcomes, adherence to these recommendations is low. The aims of this study were to explore women\u27s view of nutrition and physical activity during pregnancy and to describe barriers and facilitators experienced in implementing physical activity and nutrition recommendations. In a substudy of the Be Healthy in Pregnancy randomized trial, 20 semistructured focus groups were conducted with 66 women randomized to the control group when they were between 16 and 24 weeks gestation. Focus groups were recorded, transcribed verbatim, coded and thematically analysed. The results indicate that women felt motivated to be healthy for their baby, but competing priorities may take precedence. Participants described limited knowledge and access to information on safe physical activity in pregnancy and lacked the skills needed to operationalize both physical activity and dietary recommendations. Women\u27s behaviours regarding diet and physical activity in pregnancy were highly influenced by their own and their peers\u27 beliefs and values regarding how weight gain impacted their health during pregnancy. Pregnancy symptoms beyond women\u27s control such as fatigue and nausea made physical activity and healthy eating more challenging. Counselling from care providers about nutrition and physical activity was perceived as minimal and ineffective. Future interventions should address improving counselling strategies and address individual\u27s beliefs around nutrition and activity in pregnancy

A case analysis of partnered research on palliative care for refugees in Jordan and Rwanda

© 2021, The Author(s). Background: This case analysis describes dilemmas and challenges of ethical partnering encountered in the process of conducting a research study that explored moral and practical dimensions of palliative care in humanitarian crisis settings. Two contexts are the focus of this case analysis: Jordan, an acute conflict-induced refugee situation, and Rwanda, a protracted conflict-induced refugee setting. The study’s main goal was to better understand ways humanitarian organizations and health care providers might best support ethically and contextually appropriate palliative care in humanitarian contexts. An unintended outcome of the research was learning lessons about ethical dimensions of transnational research partnerships, which is the focus of this case analysis. Discussion: There exist ongoing challenges for international collaborative research in humanitarian conflict-induced settings. Research partnerships were crucial for connecting with key stakeholders associated with the full study (e.g., refugees with life limiting illness, local healthcare providers, aid organization representatives). While important relationships were established, obstacles limited our abilities to fully attain the type of mutual partnership we aimed for. Unique challenges faced during the research included: (a) building, nurturing and sustaining respectful and equitable research partnerships between collaborators in contexts of cultural difference and global inequality; (b) appropriate ethics review and challenges of responding to local decision-maker’s research needs; and (c) equity and fairness towards vulnerable populations. Research strategies were adapted and applied to respond to these challenges with a specific focus on (d) research rewards and restitution. Conclusions: This case analysis sheds light on the importance of understanding cultural norms in all research roles, building relationships with decision makers, and developing teams that include researchers from within humanitarian crisis settings to ensure that mutually beneficial research outcomes are ethical as well as culturally and contextually relevant

Experiences regarding nutrition and exercise among women during early postpartum: A qualitative grounded theory study

Background: Excess gestational weight gain has long- and short-term implications for women and children, and postpartum weight retention is associated with an increased risk of long-term obesity. Despite the existence of dietary and exercise guidelines, many women struggle to return to pre-pregnancy weight. Experiences of women in tackling postpartum weight loss are poorly understood. We undertook this study to explore experiences related to nutrition, exercise and weight in the postpartum in women in Ontario, Canada. Methods: This was a nested qualitative study within The Be Healthy in Pregnancy Study, a randomized controlled trial. Women randomized to the control group were invited to participate. Semi-structured focus groups were conducted at 4-6 months postpartum. Focus groups were audio recorded, transcribed verbatim, coded and analyzed thematically using a constructivist grounded theory approach. Results: Women experienced a complex relationship with their body image, due to unrealistic expectations related to their postpartum body. Participants identified barriers and enablers to healthy habits during pregnancy and postpartum. Gestational weight gain guidelines were regarded as unhelpful and unrealistic. A lack of guidance and information about weight management, healthy eating, and exercise in the postpartum period was highlighted. Conclusion: Strategies for weight management that target the unique characteristics of the postpartum period have been neglected in research and in patient counselling. Postpartum women may begin preparing for their next pregnancy and support during this period could improve their health for subsequent pregnancies

Mothers’ experiences in the Nurse-Family Partnership program: a qualitative case study

Abstract Background Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers' experiences participating in the Nurse-Family Partnership (NFP) Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant's first birthday. Methods A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently. Results The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent. Conclusions Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers' perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers' unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation.</p

How Indigenous mothers experience selecting and using early childhood development services to care for their infants

Purpose: Promoting a child’s healthy growth and development in the first six years of life is critical to their later health and well-being. Indigenous infants experience poorer health outcomes than non-Indigenous infants, yet little is understood about how parents access and use health services to optimize their infants’ growth and development. Exploring the experiences of Indigenous mothers who select and use early childhood development (ECD) services provides important lessons into how best to promote their access and use of health services. Methods: This qualitative interpretive description study was guided by the Two-Eyed Seeing framework and included interviews with 19 Indigenous mothers of infants less than two years of age and 7 providers of ECD services. Results: Mainstream (public) and Indigenous-led health promotion programs both promoted the access and use of services while Indigenous-led programs further demonstrated an ability to provide culturally safe and trauma and violence-informed care. Conclusions: Providers of Indigenous-led services are best suited to deliver culturally safe care for Indigenous mothers and infants. Providers of mainstream services, however, supported by government policies and funding, can better meet the needs of Indigenous mothers and infants by providing cultural safe and trauma and violence-informed care

Indigenous mothers’ experiences of using primary care in Hamilton, Ontario, for their infants

Purpose: Access to primary care can help mitigate the negative impacts of social inequity that disproportionately affect Indigenous people in Canada. Despite this, however, Indigenous people cite difficulties accessing care. This study seeks to understand how Indigenous mothers—typically responsible for the health of their infants—living in urban areas, experience selecting and using health services to meet the health needs of their infants. Results provide strategies to improve access to care, which may lead to improved health outcomes for Indigenous infants and their families. Methods: This qualitative interpretive description study is guided by the Two-Eyed Seeing framework. Interviews were conducted with 19 Indigenous mothers and 5 primary care providers. Results: The experiences of Indigenous mothers using primary care for their infants resulted in eight themes. Themes were organized according to three domains of primary care: structural, organizational and personnel. Conclusions: Primary care providers can develop contextual-awareness to better recognize and respond to the health and well-being of Indigenous families. Applying culturally safe, trauma and violence-informed and family-centred approaches to care can promote equitable access and positive health care interactions which may lead to improved health outcomes for Indigenous infants and their families