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Developing leadership capacity for guideline use: a pilot cluster randomized control trial.

https://arctichealth.org/en/permalink/ahliterature123925
Source
Worldviews Evid Based Nurs. 2013 Feb;10(1):51-65
Publication Type
Article
Date
Feb-2013
Author
Wendy A Gifford
Barbara L Davies
Ian D Graham
Ann Tourangeau
A Kirsten Woodend
Nancy Lefebre
Author Affiliation
School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. wgifford@uottawa.ca
Source
Worldviews Evid Based Nurs. 2013 Feb;10(1):51-65
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Diabetic Foot - therapy
Feasibility Studies
Home Nursing - education - methods - standards
Humans
Leadership
Nursing Process - organization & administration
Ontario
Pilot Projects
Practice Guidelines as Topic
Qualitative Research
Abstract
The importance of leadership to influence nurses' use of clinical guidelines has been well documented. However, little is known about how to develop and evaluate leadership interventions for guideline use.
The purpose of this study was to pilot a leadership intervention designed to influence nurses' use of guideline recommendations when caring for patients with diabetic foot ulcers in home care nursing. This paper reports on the feasibility of implementing the study protocol, the trial findings related to nursing process outcomes, and leadership behaviors.
A mixed methods pilot study was conducted with a post-only cluster randomized controlled trial and descriptive qualitative interviews. Four units were randomized to control or experimental groups. Clinical and management leadership teams participated in a 12-week leadership intervention (workshop, teleconferences). Participants received summarized chart audit data, identified goals for change, and created a team leadership action. Criteria to assess feasibility of the protocol included: design, intervention, measures, and data collection procedures. For the trial, chart audits compared differences in nursing process outcomes.
8-item nursing assessments score. Secondary outcome: 5-item score of nursing care based on goals for change identified by intervention participants. Qualitative interviews described leadership behaviors that influenced guideline use.
Conducting this pilot showed some aspects of the study protocol were feasible, while others require further development. Trial findings observed no significant difference in the primary outcome. A significant increase was observed in the 5-item score chosen by intervention participants (p = 0.02). In the experimental group more relations-oriented leadership behaviors, audit and feedback and reminders were described as leadership strategies.
Findings suggest that a leadership intervention has the potential to influence nurses' use of guideline recommendations, but further work is required to refine the intervention and outcome measures. A taxonomy of leadership behaviors is proposed to inform future research.
PubMed ID
22647197 View in PubMed
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Exploring how IBCLCs manage ethical dilemmas: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature122371
Source
BMC Med Ethics. 2012;13:18
Publication Type
Article
Date
2012
Author
Joy Noel-Weiss
Betty Cragg
A Kirsten Woodend
Author Affiliation
School of Nursing, University of Ottawa, 451 Smyth RGN3051, Ottawa, ON, Canada K1H 8M5. Joy.Noel-Weiss@uottawa.ca
Source
BMC Med Ethics. 2012;13:18
Date
2012
Language
English
Publication Type
Article
Keywords
Breast Feeding
Canada
Certification
Choice Behavior - ethics
Consultants
Decision Making - ethics
Governing Board
Humans
Interviews as Topic
Lactation
Moral Obligations
Mothers - psychology
Narration
Patient-Centered Care
Power (Psychology)
Qualitative Research
Trust
Abstract
Professional health care practice should be based on ethical decisions and actions. When there are competing ethical standards or principles, one must choose between two or more competing options. This study explores ethical dilemmas experienced by International Board Certified Lactation Consultants.
The investigator interviewed seven International Board Certified Lactation Consultants and analyzed the interviews using qualitative research methods.
"Staying Mother-Centred" emerged as the overall theme. It encompassed six categories that emerged as steps in managing ethical dilemmas: 1) recognizing the dilemma; 2) identifying context; 3) determining choices; 4) strategies used; 5) results and choices the mother made; and 6) follow-up. The category, "Strategies used", was further analyzed and six sub-themes emerged: building trust; diffusing situations; empowering mothers; finding balance; providing information; and setting priorities.
This study provides a framework for understanding how International Board Certified Lactation Consultants manage ethical dilemmas. Although the details of their stories changed, the essence of the experience remained quite constant with the participants making choices and acting to support the mothers. The framework could be the used for further research or to develop tools to support IBCLCs as they manage ethical dilemmas and to strengthen the profession with a firm ethics foundation.
Notes
Cites: Birth. 2001 Jun;28(2):77-811380377
Cites: Reprod Health Matters. 2000 May;8(15):87-9211424272
Cites: J Midwifery Womens Health. 2007 Nov-Dec;52(6):545-817983990
Cites: Monash Bioeth Rev. 2005 Oct;24(4):28-3916459429
Cites: Am J Nurs. 2006 Sep;106(9):5716954766
Cites: Am J Health Syst Pharm. 1998 Jan 1;55(1):849437480
PubMed ID
22824376 View in PubMed
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Gender of the care environment: influence on recovery in women with heart disease.

https://arctichealth.org/en/permalink/ahliterature171906
Source
Can J Cardiovasc Nurs. 2005;15(3):21-31
Publication Type
Article
Date
2005
Author
A Kirsten Woodend
Gerald M Devins
Author Affiliation
University of Ottawa, Faculty of Health Sciences, School of Nursing, Ottawa, Ontario. kwoodend@uottawa.ca
Source
Can J Cardiovasc Nurs. 2005;15(3):21-31
Date
2005
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Aged
Anxiety - etiology
Attitude to Health
Convalescence - psychology
Cross-Sectional Studies
Depression - etiology
Female
Gender Identity
Health Facility Environment - standards
Health services needs and demand
Humans
Life Change Events
Male
Men - psychology
Myocardial Infarction - complications - psychology - rehabilitation
Ontario
Organizational Culture
Psychiatric Status Rating Scales
Quality of Life
Questionnaires
Recovery of Function
Sex Factors
Stress, Psychological - diagnosis - etiology - prevention & control - psychology
Women - psychology
Women's health
Abstract
Women experience higher levels of distress than men (depression, anxiety, poor quality of life) after a first myocardial infarction. Sex differences in distress are not present in predominantly female diseases such as arthritis. This study explored the possibility that the predominantly male treatment environment for heart disease accounted for some of the sex differences in distress.
Men and women who had experienced a first-MI were asked to complete the Bem Sex Role Inventory (BSRI), a modified version of the Moos Ward Atmosphere Scale (WAS) and measures of illness intrusiveness, depression, anxiety and quality of life. Gender syntony was defined as a match between patient gender (BSRI) and the perceived gender of the treatment environment (WAS).
Women experienced higher levels of distress than men and were more likely to experience discordance between their gender and the perceived gender of the care environment (73% of women versus 32% of men). The presence of gender dystony (a mismatch between gender and treatment environment) was related to higher levels of illness intrusiveness and overall distress.
Modification of the heart disease treatment environment so that it better meets the needs of women may reduce sex differences in distress.
PubMed ID
16295795 View in PubMed
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Impacting Canadian public health nurses' job satisfaction.

https://arctichealth.org/en/permalink/ahliterature128877
Source
Can J Public Health. 2011 Nov-Dec;102(6):427-31
Publication Type
Article
Author
Karen R Graham
Barbara L Davies
A Kirsten Woodend
Jane Simpson
Shannon L Mantha
Author Affiliation
Vaccine Preventable Diseases Program, North Bay Parry Sound District Health Unit, 681 Commercial Street, North Bay, ON P1B 4E7. karen.graham@nbpsdhu.ca
Source
Can J Public Health. 2011 Nov-Dec;102(6):427-31
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Attitude of Health Personnel
Canada
Cross-Sectional Studies
Humans
Intergenerational Relations
Internal-External Control
Job Satisfaction
Logistic Models
Middle Aged
Professional Autonomy
Public Health Nursing - manpower - standards
Workload - psychology - statistics & numerical data
Abstract
Workforce recruitment and retention challenges are being experienced in public health as in other Canadian health sectors. While there are many nurses working in public health, little research has been done about their job satisfaction. Job satisfaction is linked to recruitment, retention and positive client outcomes. The purpose of this research was to examine the relationships between three modifiable work environment factors (autonomy, control-over-practice, and workload) and Canadian public health nurses' (PHNs) job satisfaction.
Data were from the 2005 National Survey of the Work and Health of Nurses (response rate, 79.7%; 18,676 nurses). Bivariate and multivariate logistic regression analyses were used for this secondary analysis. Findings were discussed with practicing PHNs, policy-makers and researchers from across Canada at a knowledge translation (KT) 'Think-Tank'.
Among the 271 PHNs, 53.5% reported being 'very satisfied' with their jobs. The interaction between autonomy and workload was a significant predictor of PHNs' job satisfaction, (OR 0.97, 95% CI 0.96-0.99, p
PubMed ID
22164552 View in PubMed
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Randomized controlled trial to determine effects of prenatal breastfeeding workshop on maternal breastfeeding self-efficacy and breastfeeding duration.

https://arctichealth.org/en/permalink/ahliterature167610
Source
J Obstet Gynecol Neonatal Nurs. 2006 Sep-Oct;35(5):616-24
Publication Type
Article
Author
Joy Noel-Weiss
André Rupp
Betty Cragg
Vicki Bassett
A Kirsten Woodend
Author Affiliation
School of Nursing, University of Ottawa, Ontario, Canada. noelweiss@rogers.com
Source
J Obstet Gynecol Neonatal Nurs. 2006 Sep-Oct;35(5):616-24
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Attitude to Health
Breast Feeding - psychology - statistics & numerical data
Female
Health Knowledge, Attitudes, Practice
Humans
Maternal Behavior
Mothers - education - psychology - statistics & numerical data
Nursing Evaluation Research
Ontario
Outcome Assessment (Health Care)
Parity
Patient Education as Topic - organization & administration
Pregnancy
Pregnant Women - psychology
Prenatal care - organization & administration
Program Evaluation
Psychological Theory
Psychology, Educational
Questionnaires
Self Efficacy
Time Factors
Abstract
To determine the effects of a prenatal breastfeeding workshop on maternal breastfeeding self-efficacy and breastfeeding duration.
Randomized controlled trial.
Large tertiary hospital in Ontario, Canada.
110 primiparous women expecting a single child, an uncomplicated birth, and planning to breastfeed.
2.5-hour prenatal breastfeeding workshop based on adult learning principles and self-efficacy theory.
Maternal breastfeeding self-efficacy and the numbers of days and amount of breastfeeding were measured at four and eight weeks postpartum. RESULTS/DATA ANALYSIS: Over time, maternal breastfeeding self-efficacy scores increased in both groups. Women who attended the workshop had higher self-efficacy scores and a higher proportion were exclusively breastfeeding compared to women who did not attend the workshop. There was little difference in the average number of days of breastfeeding, but the intervention group had less weaning.
The workshop increased maternal breastfeeding self-efficacy and exclusive breastfeeding.
PubMed ID
16958717 View in PubMed
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6 records – page 1 of 1.