Community lives of adolescents across multiple special needs: Discrimination, community belonging, trusted people, leisure activities, and friends.

We sought to gain insights into the community lives, experiences, and activities of adolescents across multiple categories of special needs. Specifically, we: explored the particular aspects of their lives adolescents felt elicited discrimination; determined whether adolescents feel a sense of community belongingness, as well as the categories of people whom adolescents approach when help is needed; and detailed the leisure activities respondents undertake and with which frequency, in addition to the quantity of friendships they have. We performed assorted descriptive analyses of the McCreary Centre Society's 2013 British Columbia Adolescent Health Survey (BCAHS) database. We found tremendous variation in the survey responses of adolescents, both within and between special needs categories, highlighting the importance of such exploratory analyses. This paper provides inductive population-based evidence to inform theories about the community lives of adolescents with special needs, as well as to guide programs and policies targeting such youth.

Predictors of Nurses' Research Use in Canadian Long-term Care Homes.

OBJECTIVES: We examined the influence of individual characteristics and organizational context features on nurses' self-reported use of research evidence in long-term care (LTC) homes. DESIGN: A cross-sectional analysis of survey data collected in the Translating Research in Elder Care program. SETTING AND PARTICIPANTS: 756 nurses (registered nurses and licensed practical nurses) from 89 LTC homes in Western Canada. METHODS: Generalized estimating equation modeling was used to identify which individual characteristics and organizational context features significantly predicted (P < .05) 3 kinds of self-reported research use by nurses: instrumental (the direct application of research findings), conceptual (using research findings to change thinking), and persuasive (using research findings to convince others). RESULTS: Nurses reported a moderate to high level of research use. There were no significant differences in mean research use scores by nursing role. Only 2 variables were associated with all 3 kinds of research use: having a positive attitude toward research, and availability of structural and electronic resources. Additional variables associated with instrumental research use were problem-solving ability, engaging in formal interactions (eg, education sessions), and better perceptions of organizational slack-staff (the availability of sufficient staff). Additional variables associated with conceptual research use were self-determination and job efficacy. Finally, additional variables associated with persuasive research use were belief suspension (the ability to suspend previously held beliefs), organizational citizenship behavior (one's voluntary commitment to the organization), self-determination, job efficacy, evaluation, and better perceptions of organizational slack-time (perceived availability of extra time). CONCLUSIONS AND IMPLICATIONS: Conceptual and persuasive research use were most strongly influenced by individual characteristics, whereas instrumental research use was predicted equally by individual and organizational variables. Nurses working in LTC are positioned in leadership roles; by targeting both the individual- and organizational-level predictors of nurses' research use, they can improve conditions for individuals living in LTC.

Pathways for best practice diffusion: the structure of informal relationships in Canada's long-term care sector.

BACKGROUND: Initiatives to accelerate the adoption and implementation of evidence-based practices benefit from an association with influential individuals and organizations. When opinion leaders advocate or adopt a best practice, others adopt too, resulting in diffusion. We sought to identify existing influence throughout Canada's long-term care sector and the extent to which informal advice-seeking relationships tie the sector together as a network. METHODS: We conducted a sociometric survey of senior leaders in 958 long-term care facilities operating in 11 of Canada's 13 provinces and territories. We used an integrated knowledge translation approach to involve knowledge users in planning and administering the survey and in analyzing and interpreting the results. Responses from 482 senior leaders generated the names of 794 individuals and 587 organizations as sources of advice for improving resident care in long-term care facilities. RESULTS: A single advice-seeking network appears to span the nation. Proximity exhibits a strong effect on network structure, with provincial inter-organizational networks having more connections and thus a denser structure than interpersonal networks. We found credible individuals and organizations within groups (opinion leaders and opinion-leading organizations) and individuals and organizations that function as weak ties across groups (boundary spanners and bridges) for all studied provinces and territories. A good deal of influence in the Canadian long-term care sector rests with professionals such as provincial health administrators not employed in long-term care facilities. CONCLUSIONS: The Canadian long-term care sector is tied together through informal advice-seeking relationships that have given rise to an emergent network structure. Knowledge of this structure and engagement with its opinion leaders and boundary spanners may provide a route for stimulating the adoption and effective implementation of best practices, improving resident care and strengthening the long-term care advice network. We conclude that informal relational pathways hold promise for helping to transform the Canadian long-term care sector.

Conducting critical ethnography in long-term residential care: experiences of a novice researcher in the field.

AIM: In this paper, I describe my experiences as a novice researcher doing a critical ethnography in long-term residential care. I reflect upon the challenges and lessons learned in navigating trust and power relations in this complex sociopolitical field. BACKGROUND: Critical ethnography is an important method of inquiry that can lead to disruptions in the status quo and empowerment of disenfranchised groups. In nursing scholarship, there is a body of literature about this method of inquiry. This paper further contributes to this scholarship by describing my experiences in the field, with particular attention to the linkages between the study's theoretical perspective, method of inquiry, and criteria for trustworthiness, and how these elements guided my actions in the field. DATA SOURCES: The study that provides the context for this paper was a critical ethnography that examined the organization of long-term residential care in British Columbia, Canada. The method of inquiry was underpinned by a theoretical perspective that wove together a postcolonial feminist approach with Foucauldian epistemology. The study's criteria for trustworthiness were: credibility, reflexivity, reciprocity, voice and praxis. DISCUSSION: Throughout the study, I found myself navigating issues related to building trust in the researcher/participant relationship and navigating power relations. Using examples, I describe how I approached these issues using the criteria for trustworthiness and theoretical perspective as guides. CONCLUSION: Critical ethnography is a method of inquiry that can enrich nursing research and educational scholarship by generating greater understanding about the complex fields in which nurses practise.

Pursuing common agendas: a collaborative model for knowledge translation between research and practice in clinical settings.

There is an emerging discourse of knowledge translation that advocates a shift away from unidirectional research utilization and evidence-based practice models toward more interactive models of knowledge transfer. In this paper, we describe how our participatory approach to knowledge translation developed during an ongoing program of research concerning equitable care for diverse populations. At the core of our approach is a collaborative relationship between researchers and practitioners, which underpins the knowledge translation cycle, and occurs simultaneously with data collection/analysis/synthesis. We discuss lessons learned including: the complexities of translating knowledge within the political landscape of healthcare delivery, the need to negotiate the agendas of researchers and practitioners in a collaborative approach, and the kinds of resources needed to support this process.

Knowledge development and evidence-based practice: insights and opportunities from a postcolonial feminist perspective for transformative nursing practice.

Although not without its critics, evidence-based practice is widely espoused as supporting professional nursing practice. Engaging with the evidence-based practice discourse from a vantage point offered by the critical perspectives of postcolonial feminism, the incomplete epistemologies and limitations of the standardization characteristic of the evidences-based movement are analyzed. Critical analysis of evidence is suggested, such that it recognizes the evidence generated from multiple paradigms of inquiry, along with contextual interpretation and application of this evidence. We examine how broader interpretations of evidence might contribute to nursing knowledge development and translation for transformative professional nursing practice, and ultimately to address persistent health disparities within the complex context of healthcare delivery.

Unclaimed treasures:older women's reflections on lifelong singlehood.

Ever-single, older women are a diverse group, whose experiences of singlehood have received little attention from researchers. In this qualitative study, eight women between the ages of 65 and 77 living in a mid-sized Southwestern Ontario city were interviewed about being ever single, including their perspectives of the benefits and drawbacks of this status at their current age. Data were collected in semi-structured interviews, and the constant comparative method was used for data analysis. Emergent themes illustrated how the women's stories of singlehood were affected by the sociopolitical contexts of their youth. Upon reflection, the women articulated the benefits of lifelong singlehood, strongly emphasizing their independence and "ability to be alone," which was viewed as very important as they aged. The drawbacks of singlehood focused on loneliness and the absence of a social support network, which took on particular importance as the women experienced increasing age and frailty. Overall, the participants expressed satisfaction with their marital status and defied common stereotypes about older, single women. Implications of these findings relate to the social structure of marital status and its impact upon the lives of women who remain single.

Gerontological content in Canadian baccalaureate nursing programs: cause for concern?

Over the next several decades the number of older Canadians will rise dramatically. This shift will have implications for the demand for health-care professionals, particularly nurses, educated to work with an aging population. The purpose of this study was to assess the status of gerontological content in Canadian undergraduate nursing curricula. Earthy's Survey of Gerontological Curricula in Canadian Baccalaureate Nursing Programs was used to collect data from a convenience sample of Canadian nursing schools and faculties with baccalaureate programs. Data were analyzed using descriptive and frequency statistics. Gerontological content was found to be integrated into the majority of programs, but only 8% of clinical hours had a focus on the nursing care of older adults and only 5.5% of students chose geriatrics for their final clinical practical prior to graduation. Implications include the need to develop faculty expertise, the potential for interdisciplinary gerontology education in the health sciences, and the need to address ageism in the nursing profession.