Rebecca Biason

Lawrence Bloomberg Faculty of Nursing

Topic

Breaking Research

Research and Innovation

Subheadline

A new study from 91�Թ�’s Lawrence Bloomberg Faculty of Nursing examines the scale of industry-sponsored events targeting health professionals

Research led by the 91�Թ�’s Lawrence Bloomberg Faculty of Nursing is shedding light on the scale of pharmaceutical industry-sponsored events that target health professionals responsible for prescribing medications.

Promotional events attended by prescribers such as physicians and nurse practitioners are a key component of marketing campaigns for new drugs and devices. But there is little transparency around their scope and extent.

In a bid to increase transparency on industry-prescriber interactions, researchers led by Assistant Professor Quinn Grundy examined data from the Centers for Medicare and Medicaid Services (CMS) Open Payments, a public database of payments made by drug and medical device companies to medical professionals.

Their study, published in JAMA Health Forum, found that there were over 1.1 million industry-sponsored events in the U.S., one of the world’s biggest pharmaceutical markets, in 2022 alone. The top 10 products – based on number of sponsored dinner events – were the focus of over 16,000 dinners sponsored by seven companies.

“Identifying over one million of these events in one year alone – and their tendency to be for specific products – should give us pause and indicate that we need to understand the prevalence of these events from a systems perspective, considering their impact on prescribing practices,” says Grundy, who is also the director of the World Health Organization (WHO) Collaborating Centre in Governance, Accountability, and Transparency in the Pharmaceutical Sector.

Grundy notes that there is already a large body of evidence on the relationship between payments and physician prescribing outcomes. Receipt of industry payments, including low-value payments for food and beverage, is often associated with physicians prescribing higher quantities of promoted and higher-cost drugs, such as brand name drugs over generics.

The Open Payments database was established under the Affordable Care Act in 2012 in the hopes of creating greater transparency around the relationships between clinicians and the pharmaceutical and medical device industries.

Using the database, researchers were able to examine records of payments from pharmaceutical and device companies to clinicians for food and beverage and to link these across matching variables to identify – and quantify – in-person sponsored events for specific products. Excluding conferences and virtual events, the numbers indicated that these industry-sponsored events were quite widespread, across various states.

What this shows, Grundy says, is that while individual health professionals may only attend a few of these events, pharmaceutical companies are sponsoring hundreds of them nationwide.

“When you think of the number of events and the number of health professionals attending these events, what emerges is a picture of a campaign that is able, at a national scale, to amplify perspectives about a promoted drug that are likely favourable to the sponsor,” says Grundy.

The study did not reveal a particular pattern in terms of the types of products that were more likely to be promoted using industry sponsored events. However, there was evidence that two of the top 10 products, both mental health-oriented drugs, had more events for nurse practitioners than physicians, indicating their importance as prescribers in the pharmaceutical market.

In 2021, the first data on industry payments to prescribing nurses was released in the U.S. Grundy says this was an important and positive step towards transparency (Canada lags behind in this regard: there is currently no data or mechanism that requires pharmaceutical or device companies to report payments to physicians or nurse practitioners).

This study, funded by the Greenwall Foundation’s Making a Difference Grants program, is part of a multi-phase project that aims to analyze the new data on industry payments to advanced practice nurses in the U.S.

Grundy says she hopes the research “sparks some conversations in professional circles about how to interact with industry in ways that are in the best interests of population health” – and leads to more research on best practices in prescribing.

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Researchers examine impact of psychosocial support program for teens with cancer

rahul.kalvapalle — Wed, 12 Jun 2024 14:59:44 +0000

Researchers examine impact of psychosocial support program for teens with cancer

rahul.kalvapalle Wed, 06/12/2024 - 10:59

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(photo by Vadym Petrochenko/iStock)

Temerty Faculty of Medicine

Topic

Breaking Research

Hospital for Sick Children

Subheadline

The Teens4Teens virtual peer support group was launched to help strengthen connections between adolescents with cancer and tackle isolation

A virtual peer support program created at the Hospital for Sick Children (SickKids) shows significant potential in helping immunocompromised teenagers cope with the challenges of social isolation and physical distancing, positively impacting their well-being, a study finds.

The study – carried out by researchers at SickKids and the 91�Թ� and published in the journal Supportive Care in Cancer – examined the impact of a program called Teens4Teens on adolescents undergoing cancer treatment.

A weekly peer support group and patient education program, Teens4Teens was launched at SickKids in 2020 with the goal of supporting the psychosocial and physical health of adolescents with cancer.

According to the study, program participants reported a number of positive impacts that included feeling relatable and understood, conveying their emotions through art, developing coping mechanisms and discussing grief and relationships with family.

“One of the biggest takeaways for teens in our study group was the peer support component,” says the study’s first author Alicia Kilfoy, a PhD student in the Lawrence Bloomberg Faculty of Nursing. “They wanted a safe space to communicate with other teens with cancer who understood what they were going through.”

An unexpected finding was that Teens4Teens also acted as a training ground for broader skills development in realms such as peer mentorship, career planning and applying to post-secondary education opportunities.

For adolescents who are immunocompromised, physical distancing can be important in managing their risk of serious infection, but it can be an especially negative experience during some of their most formative years.

“The cancer situation for teens is very unique, in that the disease hits at a time when they are trying to develop their own sense of autonomy,” says Kilfoy’s supervisor and study co-author Lindsay Jibb, a scientist in the Child Health Evaluative Services program at SickKids and assistant professor at the Lawrence Bloomberg Faculty of Nursing. “Resources in pediatric oncology are often not tailored to this age group, and so this support program, according to our results, appears to be a step in the right direction.”

(L-R) Alicia Kilfoy, Lindsay Jibb and Chana Korenblum (supplied images)

Teens4Teens was originally designed by Chana Korenblum, a staff physician in SickKids’s division of adolescent medicine and assistant professor in the department of paediatrics in 91�Թ�’s Temerty Faculty of Medicine.

It was implemented for young cancer patients during the COVID-19 pandemic, with the aim of providing teens with a space to connect through virtual sessions with speakers who engaged them on an array of topics related to cancer and also generally on navigating life as a teen.

Sessions were moderated by child life specialists and included guest speakers from various disciplines including nursing and creative art therapy. Each group was involved in addressing coping strategies for grief and navigating difficult feelings using activities such as music and art therapy.

“Teens told us they valued having a space where all thoughts and feelings about cancer were welcome, where they could share their stories and swap coping strategies without judgment – and most importantly, where they felt a strong sense of belonging and connectedness,” says Korenblum.

One of the big draws for teens to participate in the program was the desire to regain a sense of control. Many participants in the study reported challenges associated with feeling excluded from decision-making in their own lives – including around their medical treatment – and the negative impact of cancer on their sense of self and relationships with others.

“We also saw teens reporting that the program normalized their cancer experience in a developmentally appropriate way, and changed the way health providers were engaging with them as patients,” says Jibb, who also holds the Signy Hildur Eaton Chair in Paediatric Nursing Research at SickKids.

The study also delved into participants’ suggestions for improvement, which included making the program hybrid to provide more opportunities for in-person social connection. The researchers say the teens’ feedback will help them fine-tune and augment the program to increase recruitment, engagement and impact.

The study comes amid a growing recognition within the oncology field of the need for teen-centred programming, with Teens4Teens showing promise as a low-cost, feasible intervention.

“Adolescence can be tricky to navigate, and a cancer diagnosis can add many bumps to the road,” says Jibb. “I’m excited to see how this program continues to grow in support of teens with cancer.”

Robyn Stremler appointed dean of Lawrence Bloomberg Faculty of Nursing

rahul.kalvapalle — Mon, 22 Apr 2024 15:02:12 +0000

Robyn Stremler appointed dean of Lawrence Bloomberg Faculty of Nursing

rahul.kalvapalle Mon, 04/22/2024 - 11:02

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(photo by Rebecca Biason)

Topic

Bloomberg Faculty of Nursing

Subheadline

Professor Stremler is internationally recognized for her research in infant and adolescent sleep

Professor Robyn Stremler, a renowned nursing researcher, will become the next dean of the 91�Թ�’s Lawrence Bloomberg Faculty of Nursing following an extensive international search.

Stremler, who is currently the acting dean for the faculty, will serve a five-year term that begins May 15, 2024 and extends until June 30, 2029.

“As a Bloomberg Nursing alumni and faculty member, I am honoured to serve as dean and I am extremely proud to be a part of such a diverse community of students, faculty, staff and alumni who consistently strive for excellence and innovation in nursing research, education and practice,” says Stremler. “We are the top-ranked school of nursing in Canada, and I look forward to seeing our growth and progress ahead as we continue to inspire and educate future nurse leaders.”

Stremler will be replacing former dean Linda Johnston, who completed a 10-year term and led the faculty through many developments including the challenges of the COVID-19 pandemic. Johnston was committed to initiatives that supported the values of the faculty including the creation of the Doctor of Nursing program and the establishment of the Equity, Diversity, Inclusion and Indigenous Reconciliation Committee.

“I want to thank Linda Johnston for her immense contributions to Bloomberg Nursing in her time as dean,” says Stremler. “Her leadership and advocacy has positioned the faculty for continued success and elevated its reputation as a leading academic and research institution.”

An adjunct scientist at the Hospital for Sick Children, Stremler is an accomplished clinician and researcher who is internationally recognized for her ground-breaking research in infant and adolescent sleep.

Her research program, funded by the Canadian Institutes of Health Research (CIHR), focuses on improvements in pediatric and adolescent sleep quality and sleep promotion using digital and wearable technological interventions. Some of her recent research includes a team grant with the Sleep Research Consortium to examine sleep equity and intersectional theoretical frameworks to optimize sleep health for all Canadians.

For her distinguished scholarly contributions, Stremler has earned prestigious fellowships from the American Academy of Sleep Medicine and the American Academy of Nursing, and awards for leadership in research excellence from the Ontario Ministry of Research and Innovation and Registered Nurses Association of Ontario, among others.

“I am delighted that Professor Stremler has been named as the new dean of the Lawrence Bloomberg Faculty of Nursing,” said Trevor Young, 91�Թ�'s vice-president and provost. “Professor Stremler is a dedicated clinician and researcher who is passionate about the nursing profession and about providing our students with the skills and resources they need. A committed educator and mentor, she has been an active leader in the faculty since 2015, and has been a tremendous force in supporting the professional development of students at all levels, as well as front-line nurses.”

Stremler served as director of the PhD program at Bloomberg Nursing from 2015 to 2018, and in 2023 served as the associate dean, academic. She is credited for being intentional and committed to the betterment of nursing education through curriculum improvements and collaboration with key partners in nursing education including the Toronto Academic Health Science Network (TAHSN). Her ability to build strong relationships with students across undergraduate and graduate programs has been deemed instrumental to sustaining a strong sense of community and focus on equity.

Bloomberg Nursing is home to leading nurse scientists and has graduated more than 11,000 alumni at the top of their fields, many of whom actively work with partners from around the world to improve quality of life and treatment options for populations across the life span.

Stremler’s appointment as dean comes at a time when the nursing profession is undergoing significant change as it tackles challenges of retention, recruitment and equitable access to health care.

Stremler says she’s looking forward to expanding the faculty’s investment in future nurse leaders who will improve health care and health systems worldwide. “Bloomberg Nursing has always been a leader in cutting-edge research and innovation exploring the relevant healthcare challenges of our time, which includes our ability to sustain a healthy and engaged nursing workforce,” she says.

“Our commitment to nursing excellence will continue to be centered around the dismantling of barriers to equitable access to care, and an evidence-based approach to ensuring the voices of nurses are at the forefront of health system change.”

Researchers find early symptoms of psychosis spectrum disorder in youth accessing mental health services

Christopher.Sorensen — Wed, 31 Jan 2024 20:47:42 +0000

Researchers find early symptoms of psychosis spectrum disorder in youth accessing mental health services

Christopher.Sorensen Wed, 01/31/2024 - 15:47

Cutline

(photo by SeventyFour/iStock)

Centre for Addiction and Mental Health

Topic

Breaking Research

Youth

Subheadline

Half of youth aged 11-24 who were included in the study met the threshold for psychosis spectrum symptoms – more than researchers anticipated

Researchers at the 91�Թ� and the Centre for Addiction and Mental Health (CAMH) have found evidence that psychosis spectrum symptoms are often present in youth accessing mental health services.

Half of the 417 youth aged 11-24 included in the study, published in Biological Psychiatry: Cognitive Science and Neuroimaging, were shown to meet the threshold for having psychosis spectrum symptoms.

That means they are at higher risk of developing a psychotic disorder, a broad spectrum of psychotic disorders that includes – but is not limited to – schizophrenia and bipolar disorder 1.

Kristin Cleverley (supplied image)

Kristin Cleverley, a senior scientist at CAMH and an associate professor at 91�Թ�’s Lawrence Bloomberg Faculty of Nursing, says the figure is higher than expected and suggests there is a large number of children with these symptoms who are accessing mental health services.

“Traditionally, early psychosis care starts when there is a serious presentation of psychotic symptoms, which usually occurs in the late teen years,” says Cleverley, adding that the study looks at early indicators that might predict whether a young person is more at risk of developing psychosis spectrum disorder and examines opportunities for earlier intervention.

“The current approach to identifying children at risk of developing a psychotic disorder is only about five per cent effective, but with this study we can start to assess certain patterns or changes in function that can signal if an earlier intervention may be beneficial.”

Psychosis spectrum disorder can be extremely disabling and is linked to cognitive impairment, long-term disability, and higher rates of death by suicide than other mental illnesses. Even without a diagnosis of psychosis, psychosis spectrum symptoms can severely affect youth.

The study is one of three projects being led as part of the Toronto Adolescent and Youth (TAY) Cohort Study that is set to follow 1,500 youth over the course of five years. The goal of the study is to better understand the populations of youth seeking mental health treatment, how their mental health symptoms and functioning change over time, and whether early predictors of psychosis spectrum disorder can be determined.

It was co-designed with patients and caregivers, as well as extensive engagement from clinicians. A novel aspect of the TAY Cohort Study is youth are given access to a patient-facing dashboard of their research results that is also integrated into their clinical record.

“We wanted to ensure that the study was embedded in the clinical program so that research assessments could be immediately utilized within clinical practice, including supporting decisions about interventions or services,” says Cleverley, who is the CAMH Chair in Mental Health Nursing Research.

Cleverley’s co-principal investigators include George Foussis, the scientific director of the Slaight Family Centre for Youth in Transition and chief of the schizophrenia division at CAMH and an associate professor of psychiatry in the Temerty Faculty of Medicine, and Aristotle Voineskos, vice-president of research and director of the Campbell Family Mental Health Research Institute at CAMH, and a professor of psychiatry at Temerty Medicine.

This longitudinal study will include a follow-up every six months and will provide researchers access to information about whether symptoms become chronic or episodic, and whether changes are related to developmental milestones, environmental stressors or changes to mental health services.

“Our goal with this research is really to characterize this population better so that we can identify new strategies that will complement existing strategies for early identification of youth at risk of psychosis,” says Cleverley. “It also creates an important opportunity for graduate students and researchers to develop sub-studies for this sample that will enable further research to improve youth mental health outcomes.”

Researcher uses AI to understand how healthy older adults are aging at home

Christopher.Sorensen — Mon, 23 Oct 2023 16:33:13 +0000

Researcher uses AI to understand how healthy older adults are aging at home

Christopher.Sorensen Mon, 10/23/2023 - 12:33

Cutline

Charlene Chu, an assistant professor in 91�Թ�’s Lawrence S. Bloomberg Faculty of Nursing, examines the intersections of technology and older adults’ health and well-being (photo by Robert Frost Photography)

Topic

Faculty of Applied Science & Engineering

Aging

Artificial Intelligence

University Health Network

Subheadline

“We know a lot about older adults who are ill or who have multi-morbidities, but we don’t have much insight into older adults who are aging in positive and healthy ways”

91�Թ� nursing researcher Charlene Chu wants to know how older adults age at home – and she’s using artificial intelligence to help.

An assistant professor in the Lawrence S. Bloomberg Faculty of Nursing, Chu is examining the intersections of technology and older adults’ health and well-being. Her current research uses a multi-modal AI-based sensor system called MAISON (Multimodal AI-based Sensor platform for Older iNdividuals) to help fill in knowledge gaps in the field.

MAISON uses a wearable watch as well as a variety of sensors such as sleep mats, motion detectors and chair mats to collect information on the wearers’ physiology, including heart rate, blood pressure and quality of sleep. It also detects participants’ levels of activity, including how far they can travel from home.

“We know a lot about older adults who are ill or who have multi-morbidities, but we don’t have much insight into older adults who are aging in positive and healthy ways,” Chu says. “With the rapid advancements in AI and its deployment across multiple sectors, thoughtful examination is required to determine how we can ensure older adults benefit from AI so that no one is left behind.”

Chu is the recipient of a multi-year National Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant, which supports innovation in engineering science. This will fund three interrelated projects including the design and deployment of the MAISON app interface that will help Chu and co-investigator Shehroz Khan, a scientist at the KITE Research Institute, University Health Network and an assistant professor at 91�Թ�’s Institute of Biomedical Engineering, develop a database that will provide a nuanced understanding of how healthy older adults age actively in their communities.

The database will be the first of its kind in Canada to include information on the age, sex, gender and socio-economic status of older adults and how this correlates to their ability to age at home.

The overarching goal, Chu says, is to make the database accessible to researchers from around the world, creating the potential for machine learning models to accurately predict outcomes of active aging and inform the design of new technologies – all with older adults acting as key partners in the process.

“These three projects and the app we are creating will be focused on gathering data from people who manage their own health conditions,” says Chu. “We hope to gain a holistic perspective of aging, incorporating feedback from older adults about what they think is important to include in an app that measures their lifestyle and health.”

The detailed information collected by MAISON increases the researchers ability to understand how factors like socio-economic status, geographic location, community features, age, sex and gender impact the aging process, Chu adds. This is important, she notes, because technology for older adults is often subject to bias or digital ageism – problems she has highlighted in earlier research.

“There is a difference between older adults who are 65 versus those who are 75. We cannot lump together everyone who is 55 and older when we design technology and applications for older adults, but this is what is happening now,” Chu says.

The MAISON system and app interface is currently being used to assess and monitor the activity of older adults who have been discharged from inpatient rehabilitation following hip surgery, helping to demonstrate the technical feasibility of Chu’s latest project.

“Digital ageism partially stems from a lack of data on older adults, including poor labelling and lack of access to technology,” Chu says. “With this project I’m hopeful that we will begin to overcome those barriers.”

Nursing student seeks to foster change and diversity in health care

Christopher.Sorensen — Thu, 05 Oct 2023 13:09:18 +0000

Nursing student seeks to foster change and diversity in health care

Christopher.Sorensen Thu, 10/05/2023 - 09:09

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Kyle Samuels, a master’s student at 91�Թ�’s Lawrence S. Bloomberg Faculty of Nursing, says he wants to provide competent and compassionate care to patients from different cultural and socio-economic backgrounds (supplied image)

Topic

Subheadline

“Many people do not realize the impact that representation can have"

Kyle Samuels didn’t plan to become a nurse.

“I actually thought I was going to be veterinarian,” says Samuels of his original career plan.

But after completing his first degree in animal biology, he worked at an Ontario zoo and later a vet clinic before realizing he needed to make a change.

“It was when I was applying to vet school that it dawned on me that maybe this isn’t for me. I couldn’t come up with an answer to the question, ‘Why do I want to be a vet?’” says Samuels, who is now starting the first year of his master’s degree in nursing at the 91�Թ�’s Lawrence S. Bloomberg Faculty of Nursing.

Now working as a registered nurse, Samuels, who is in the nurse practitioner program, has developed a passion for expanding his scope of practice to better serve his patients.

He currently works at a hospital in a more rural area of southern Ontario in the medicine/surgical intensive care unit. Within this smaller 80-bed hospital setting, Samuels says nurses have an opportunity to be a part of an interdisciplinary health team, and to care for a variety of patients throughout their health journey.

Historically, however, nurse practitioners are not often hired into hospital settings in smaller communities, and Samuels is hoping to see that change.

“I want to help play a role in fostering growth in health-care spaces for nurse practitioners,” he says. “We have a lot to offer that could help the health-care system as a whole, and serve the health of everyone.”

By becoming a nurse practitioner, Samuels realizes he has a unique opportunity to play a part in increasing the level of diversity and representation of Black nurses in Ontario’s small communities.

“I work with many people from different ethnicities and backgrounds who are nurses, but when I think about that next step in leadership and autonomy, it would be amazing to see more people of colour moving into the [nurse practitioner] space,” says Samuels.

Samuels says a patient once said he was the first health-care provider who looked like him.

“That really stuck with me,” says Samuels. “Many people do not realize the impact that representation can have, especially in health care, where there is such a power dynamic at play between the vulnerable patient and those providing care. It is one of the many reasons I’m so excited to be pursuing a degree as a nurse practitioner.”

Samuels is looking forward to the placement opportunities that the Bloomberg Nursing program offers. He wants to work with patients from different cultural and socio-economic backgrounds to provide competent and compassionate care.

“That’s why I chose Bloomberg Nursing at 91�Թ�,” says Samuels. “The [nurse practitioner] program here is unique – you have an opportunity to work in placements in a hospital setting in addition to other community organizations, and there are avenues to gain skills as a researcher, which throws open the doors to future possibilities including potentially pursing a PhD.”

For now, Samuels is ready to settle into the program and learn as much as he can to provide as a future nurse practitioner, including how to remain an advocate for patients ensuring that they always receive the best quality of care.

Researchers examine mental health and well-being of Canada’s unpaid caregivers

siddiq22 — Fri, 21 Jul 2023 18:00:11 +0000

Researchers examine mental health and well-being of Canada’s unpaid caregivers

siddiq22 Fri, 07/21/2023 - 14:00

Cutline

(photo by Patricia Kovac/iStockphoto)

Topic

Canadian Institutes of Health Research

Aging

Mental Health

Subheadline

New study looks at how race, ethnicity, sex, gender and age impact the experiences of unpaid caregivers across the country

A new nationwide study led by Monica Parry, a professor in the Lawrence S. Bloomberg Faculty of Nursing, will examine the intersections of race, ethnicity, sex, gender and age as they relate to the health and well-being of unpaid caregivers.

The study, which will be conducted by Parry and a team of researchers from across Canada, is funded by the Canadian Institutes of Health Research.

Monica Parry (supplied image)

Parry notes that almost one-third of Canadians provide unpaid caregiving – which can encompass personal, psychological, physical, social and financial care for someone with a long-term health condition, disability or with increased needs due to aging. In 2020, Parry conducted a six-month rapid review of the experiences of unpaid caregivers, with a particular focus on the impact of the COVID-19 pandemic.

Her study found that caregivers were reporting over 40 hours of unpaid caregiving per week – the equivalent of a full-time job. But the respondents were not necessarily reflective of the Canadian population.

“Race and ethnicity were not well reported – and yet we know that almost one in five people in Canada are born outside the country, so there is a large gap in our understanding of the health and well-being of a significant portion of the population and their caregiving experience,” Parry says.

This is significant because unpaid caregivers are often faced with increased health risks. Parry’s previous study found that unpaid caregiving was associated with high amounts of stress, anxiety and depression – which in turn can lead to the development of chronic illness such as cardiovascular disease, in addition to ongoing negative impacts on mental health.

To ensure that this current study is more reflective of Canada’s population, the research team is working closely with partners in the community – including the Pentecost International Worship Centre, the Council for Agencies Serving South Asians and the Yee Hong Centre for Geriatric Care, among others – to recruit participants.

Parry and her collaborators are also encouraging those who identify as unpaid caregivers and who are 18 or older to consider participating by completing an online survey.

The study includes an engagement advisory committee made up of unpaid caregivers who have shared their lived experiences in a series of videos to encourage participation from their peers.

“We have heard from our members of the community that until they had taken our survey, they had not recognized their own needs as caregivers and the impact of caregiving on their health,” Parry says.

“I think this illustrates just how important this study is in helping us understand what caregivers are experiencing and what they will need in the future.”

Parry adds that as a result of the pandemic, unpaid caregiving is increasing because many people simply do not want to see their family members or friends in long-term care settings, which were hit hard by COVID-19.

Caregivers are doing “heroic things” just to keep their loved ones at home, often juggling caregiving with everyday work and family responsibilities, Parry says.

“We truly want to include the voices of all unpaid caregivers and paint a full picture of what their needs are, and how caregiving impacts them.”

91�Թ� researcher leads study on parenting resources for Indigenous fathers and Two-Spirit individuals

siddiq22 — Tue, 04 Jul 2023 20:16:27 +0000

91�Թ� researcher leads study on parenting resources for Indigenous fathers and Two-Spirit individuals

siddiq22 Tue, 07/04/2023 - 16:16

Cutline

(photo by FatCamera/Getty Images)

Topic

Indigenous

LGBTQ

Research

Subheadline

The Fathers of the Next Generation study is collaborating with Indigenous fathers and community members to learn more about what resources could support them in their parenting journey

Amy Wright, a nurse practitioner and researcher at the 91�Թ�’s Lawrence S. Bloomberg Faculty of Nursing, is collaborating with Indigenous fathers and community members to build a set of parenting resources aimed specifically at supporting men and Two-Spirit people along their journey into parenthood.

The Fathers of the Next Generation study, which is funded by the Canadian Institutes of Health Research, is built on a previous scoping study conducted by Wright that revealed gaps in available resources for fathers, and the need for them and their partners to be able to access resources related specifically to their experiences and transition into parenthood.

Though the study is still in its early stages, Wright said that it has already been informative to hear from fathers during ongoing consultations and the interview process.

Amy Wright (supplied image)

“This is much bigger than the Western conceptualization of what a parenting program should look like – it is more holistic and culturally and emotionally centered, instead of task-based,” Wright says.

“Yes, they want to know about diapering and supporting their partner in breastfeeding, but they also want to know more about their traditional role as a father; how to spiritually guide their children. Some are on a healing journey, and are interested in understanding how to be a father in relation to how they have been fathered.”

The study’s steering committee, which includes members from the Six Nations of the Grand River, has been essential not only in recruiting fathers to take part in the study, but also in providing important insights and guidance around developing the study using Indigenous ways of knowing.

“There is a deep and recurring theme among the fathers we have interviewed that points to their desire to communicate and ground their parenting within their culture and spirituality alongside other important aspects of parenting like nutrition, health and emotional needs,” Wright says.

Wihse Spring (supplied image)

Committee member Wihsé Spring, who identifies as a Two-Spirit father, wanted to contribute to the study because of his own experience entering fatherhood – and also because of the way he has seen fathers often treated.

“Sometimes it can seem like dads are just a decoration – and that’s not true. We want to have the resources to get rid of that label and have the confidence moving forward to not only be good fathers, but also explore the connection to our culture and community,” Spring says.

What role fathers played before colonization and how to be an Indigenous father are key questions that have come up in the early stages of the study. When asked about what specific resources would be beneficial, most of the fathers participating in the study said they were keen to see in-class workshops around parenting facilitated by fathers, and to be role models in their own healing if they grew up without a father.

“An important element that came out of our previous scoping study was a desire from the men to build a network of peers where fathers can learn from and support one another,” Wright says.

“Having meals together or participating in traditional or on-the-land activities would also help break down any barriers of engagement and encourage fathers to seek out health promotion programs and prenatal/postnatal resources.”

David Johnson (supplied image)

Parenting in a positive manner and stopping a perpetual cycle of generational trauma is what motivated David Johnson, a registered nurse and member of the Six Nations of the Grand River community, to participate in the study as a member of the steering committee – and to encourage other new fathers in his community to also take part.

Johnson describes himself as a changemaker – as a proud father to two young girls, he acknowledges he has been fortunate to have had his parents in his life to learn from and lean on for support.

But he says many of his peers are facing child custody issues, or negative assumptions about themselves as fathers, which is why he encourages them to have their voice heard through the study in the hopes of revitalizing the role of fathers.

“Lots of men in my generation are stepping up as fathers, and having a variety of resources – including workshops taught by other fathers – will just hit closer to home,” Johnson says.

“Showing men how to be more in touch with expressing themselves, working through their own healing journey and helping them to not deviate from the main goal of supporting their kid, could make a world of difference.”

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Parenting

New nursing simulation project promotes gender-affirming care for 2SLGTBQIA+ community

siddiq22 — Thu, 29 Jun 2023 17:06:07 +0000

New nursing simulation project promotes gender-affirming care for 2SLGTBQIA+ community

siddiq22 Thu, 06/29/2023 - 13:06

Cutline

Nursing student Richard Tang (centre) with Laura Fairley (left) and Erica Cambly, assistant professors in the Lawrence S. Bloomberg Faculty of Nursing (photo by Neal MacInnes)

Topic

Experiential Learning

health care education

Simulation

Health

LGBTQ

Richard Tang, a student in the Master of Nursing program at the Lawrence S. Bloomberg Faculty of Nursing, has led the co-creation of a new simulation – a type of experiential learning – for undergraduate nursing students that is focused on providing specialized care to the 2SLGBTQIA+ community.

Tang, who recently won the poster competition at the Canadian Association of Schools of Nursing (CASN) Conference for the project, was motivated to create the new simulation to bring queer health to the forefront of the nursing curriculum.

“Gender dysphoria is an ingrained conceptualization in the care that is sometimes provided to the transgender community, and we wanted to shift that perspective among our nursing students,” Tang says.

Learning in a simulation environment, adds Tang, provides students and educators a chance to understand best practices for trans care and identify pre-existing assumptions and biases without harming or traumatizing a patient.

The new simulation module takes place in the community health unit of the Bloomberg Nursing Simulation Lab, which can be transformed into a home care setting.

Faculty collaborators, including Laura Fairley and Erica Cambly – both assistant professors – helped to create the simulation environment that features a client who is a trans man recovering from top/chest surgery at home.

Using a state-of-the art mannequin complete with drainage tubes and the ability to speak (voiced by Fairley), students learn how to look after the client through what Tang describes as a joyous approach to care.

The project used a mannequin to simulate post-operative recovery from chest surgery (photo by Richard Tang)

Students must also address some of the complex challenges that arise for their client, which include management of post-operative complications, lack of access to a primary care provider, as well as the need to address additional social determinants of health.

“In all of our current work in the simulation lab, we lay a solid theoretical groundwork for students to learn how to provide trans-competent care,” says Fairley, who is a nurse with extensive experience caring for people recovering from transition-related surgeries.

“What is unique about this new simulation is that it goes beyond the theoretical and allows for students to visibly challenge cisnormativity and recognize that trans health care is ubiquitous in all types of nursing.”

Fairley further points out that members of the trans community experience significant discrimination when attempting to access transition-related medical care, but with Toronto considered a national hub for transition services, this is a specific type of knowledge that nurses will need to know – whether in primary care, the ER, acute care, or home-care settings across the province.

Creating this type of simulation requires intense collaboration – from the development of the storyline and preparatory materials, to the input of community members that it impacts.

In addition to Cambly and Fairley’s expertise in simulation learning and trans health care, a member of the trans community was also invited to review the simulation for accuracy alongside community-health nurses with expertise in transition-related care.

Cambly, who leads the simulation curriculum in the faculty, says that the clear standards and best practices for developing a simulation – which include looking for hidden biases and ensuring that there are clear learning objectives – are what help make a new simulation rollout successful.

She says this particular simulation was piloted with first- and second-year students in the undergraduate nursing program, with students being given an opportunity to debrief and provide feedback about how the simulation flowed, and what could be done better.

“I think one of the things we noticed during the pilot was that the students were really pleased we were doing this work and making this simulation available to all students,” Cambly says.

“Some of our students are living with transphobia, or have seen examples of it in their everyday life, and they see how important this knowledge is for health-care providers.”

The new simulation will likely be ready to be added to the 2023-2024 nursing curriculum – an important step in ensuring students are well-equipped to provide equitable and inclusive health care.

For Tang, the opportunity to blend his passion for teaching and learning with a chance to make a positive impact for students and the queer community is rewarding.

“I’m reassured that we are headed in the right direction in achieving these community-practice goals,” Tang says.

“We are not only making positive changes to the curriculum, but also addressing the diverse needs of the populations we serve.”

Nursing PhD graduate creates toolkit to improve communication for ICU patients

Christopher.Sorensen — Tue, 06 Jun 2023 17:02:11 +0000

Nursing PhD graduate creates toolkit to improve communication for ICU patients

Christopher.Sorensen Tue, 06/06/2023 - 13:02

Cutline

Laura Istanboulian, a new graduate of the Lawrence S. Bloomberg Faculty of Nursing, created a “communication bundle” to help solve a decades-old problem in hospital ICUs (supplied photo)

Topic

Medical Research

Nursing

PhD