Resilience for working in Ontario home and community care: registered practical nurses need the support of themselves, family and clients, and employers.

BACKGROUND: The context of practice is often not explicit in the discourse around the personal and professional resilience of nurses. The unique factors related to providing nursing care in home and community care may provide novel insight into the resilience of this health workforce. Therefore, this research addressed how nurses build and maintain resilience working in the home and community care sector. METHOD: A qualitative study was conducted between November 2022 to August 2023 using 36 in-depth interviews (29 registered practical nurses [RPNs], five supervisors of RPNs, two family/care partners (FCPs) of clients receiving home and community care services). Analysis was consistent with a grounded theory approach including coding and comparative methods. RESULTS: The factors of personal and professional resilience were not distinct but rather mixed together in the experience of nurses having resilience working in the home and community care sector. The process of building and maintaining resilience as home and community care nurses was informed by three categories: (1) The conditions of working in HCC; (2) The rapport RPNs held with FCPs; and (3) The nurses' ability for supporting the 'self'. Multiple components to inform these categories were identified and illustrated by the words of the nurse participants. CONCLUSION: The process of building and maintaining resilience by RPNs working in the home and community care sector was guided by the day-to-day experiences of providing care for clients and the conditions of being a mobile health care provider. However, nurses may sense when they need to support their 'self' and must be empowered to request and receive support to do so.

Nurses' Descriptions of Interdisciplinary Interactions in Stroke and Geriatric Rehabilitation Units: A Case Example of the Registered Practical Nurse.

AIM: To analyse how nurses describe their interactions with other interdisciplinary team members within stroke and geriatric rehabilitation. DESIGN: A secondary analysis of cross-sectional ethnographic interview data was conducted using Elo and Kyngäs' (2008) deductive content analysis. METHODS: Between April 12 and July 25, 2022, semi-structured interviews were conducted with 31 registered practical nurses recruited through convenience sampling from three tertiary hospital sites in Southwestern Ontario. Interview transcripts were reviewed to identify described interactions between nurses and interdisciplinary team members and were coded for: who were the interdisciplinary team member(s) involved; what content was addressed; and where, when, and why the interaction occurred. RESULTS: Categories representing how nurses describe their interactions with interdisciplinary team members were as follows: (1) arising from the unique roles owned by either the nurse or interdisciplinary team member(s); (2) requiring open communication to achieve patient goals and improve patient care; (3) occurring within what is perceived to be either the therapists' or nurses' physical space; and (4) contributing to supportive team environments that are mutually beneficial. CONCLUSIONS: While nurses view other interdisciplinary team members as 'owning' certain roles and physical spaces within rehabilitation, they also recognised their 'owned' spaces and roles. Unique contributions of all team members were valued as necessary to provide holistic, person-centred patient care and positive team-based support. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses' descriptions of their interactions with interdisciplinary team members demonstrated their essential contributions to team-based patient care and acknowledged nurse contributions to the rehabilitation process for patients. IMPACT: Findings elucidate the nature of interprofessional interactions and 'ownership' within the rehabilitation process. Results are beneficial for policymakers, educators, and healthcare organisations aiming to optimise the nursing role within rehabilitation spaces. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Resilience in home and community care registered practical nurses: a scoping review.

Critical nursing shortages and experiences of burnout present a significant challenge in the home and community care (HCC) health sector. Determining what factors influence resiliency could inform HCC organizations in developing recruitment and retention resources and strategies. This scoping review identified factors that influence professional resilience in nurses working in the HCC sector. From 1819 documents identified from database searches, using a librarian-informed strategy, eight articles were included. Two domains emerged for HCC nurses, that is, i) professional and work-related characteristics of being resilient; and ii) strategies to promote professional nurse resilience. One domain emerged addressing organizational infrastructure, policy and practices contributing to professional nurse resilience in the HCC sector. The findings revealed that resiliency in HCC nurses extends beyond individual characteristics as nurse professionals, and their personal "self-care" strategies as individual people. Further research is needed to disentangle personal and professional resilience in nurses working in the HCC sector.

A Leave of Absence Might Not Be a Bad Thing: Registered Practical Nurses Working in Home Care During the COVID-19 Pandemic.

To describe the resilience and emotional intelligence of Registered Practical Nurses working in Home and Community Care during the COVID-19 pandemic. Specifically, to determine if there was a relationship between resilience and emotional intelligence based on whether a nurse: (1) left the sector, (2) considered leaving, or (3) took a leave of absence during the pandemic. An online cross-sectional survey was used to capture respondents' demographic information and scores on the Connor-Davidson Resilience Scale, Resilience at Work Scale®, and Wong and Law Emotional Intelligence Scale. Registered Practical Nurses working, or who had worked, in Home and Community Care January 2020 to September 2022 were eligible to participate. The Checklist for Reporting Results of Internet E-Surveys was used. The survey was available June to September 2022 and advertised by the Registered Practical Nurses Association of Ontario to approximately 2105 members. Descriptive statistics and independent samples t-tests were used to analyze results at a level of P < .05 was used for all analyses. A total of 672 respondents participated (completion rate = 92.8%). There were no differences on resilience or emotional intelligence scores based on whether a nurse left, or considered leaving, the Home and Community Care sector during the pandemic. However, nurses who took a leave of absence scored significantly higher on resilience and emotional intelligence measures when compared to those who did not. Results suggest that a leave of absence for these nurses during the pandemic may have been a supportive coping strategy.

Accreditation as a driver of interprofessional education: the Canadian experience.

BACKGROUND: The purpose of this study was to (1) explore evidence provided by Canadian health and social care (HASC) academic programs in meeting their profession-specific interprofessional education (IPE)-relevant accreditation standards; (2) share successes, exemplars, and challenges experienced by HASC academic programs in meeting their IPE-relevant accreditation standards; and (3) articulate the impacts of IPE-relevant accreditation standards on enabling interprofessional learning to the global HASC academic community. METHODS: Profession-specific (bilingual, if requested) surveys were developed and emailed to the Deans/Academic Program Directors of eligible academic programs with a request to forward to the individual who oversees IPE accreditation. Responses were collated collectively and by profession. Open-ended responses associated with our first objective were deductively categorized to align with the five Accreditation of Interprofessional Health Education (AIPHE) standards domains. Responses to our additional questions associated with our second and third objectives were inductively categorized into themes. RESULTS/DISCUSSION: Of the 270 HASC academic programs surveyed, 30% (n = 24) partially or completely responded to our questions. Of the 106 IPE-relevant standards where evidence was provided, 62% (n = 66) focused on the Educational Program, 88% of which (n = 58) were either met or partially met, and 47% (n = 31) of which focused on practice-based IPE. Respondents cited various exemplars and challenges in meeting IPE-relevant standards. CONCLUSIONS: The overall sentiment was that IPE accreditation was a significant driver of the IPE curriculum and its continuous improvement. The array of exemplars described in this paper may be of relevance in advancing IPE implementation and accreditation across Canada and perhaps, more importantly, in countries where these processes are yet emerging.

Resilience amongst Ontario registered practical nurses in long-term care homes during COVID-19: A grounded theory study.

AIMS: This study aimed to understand how the personal and professional resilience of Registered Practical Nurses working in long-term care (LTC) homes in Ontario were impacted during the Coronavirus 2019 pandemic. BACKGROUND: Registered Practical Nurses are primary regulated healthcare providers that have worked in Ontario LTC homes during the COVID-19 pandemic. As frontline workers, they have experienced increased stress secondary to lockdowns, changing Ministry of Health recommendations, social isolation and limited resources. LTC homes experienced almost a third of all COVID-19-related deaths in Ontario. Understanding registered practical nurses' (RPNs) resilience in this context is vital in developing the programs and supports necessary to help nurses become and stay resilient in LTC and across a range of settings. METHODS: Purposive sampling was used to recruit 40 Registered Practical Nurses working in LTC homes across Ontario for interviews. Charmaz's Grounded theory guided in-depth one-on-one interviews and analyses completed between April to September 2021. RESULTS: Registered Practical Nurse participants represented 15 (37.5%) private, and 25 (62.5%) public LTC homes across Ontario Local Health Integration Networks. Findings informed two distinct perspectives on resilience, one where nurses were able to maintain resilience and another where they were not. Sustaining and fraying resilience, presented as bimodal processes, was observed in four themes: 'Dynamic Role of the Nurse', 'Preserving Self', 'Banding Together' and 'Sense of Leadership Support'. CONCLUSION: Resilience was largely drawn from themselves as individuals. Resources to support self-care and work-life balance are needed. Additionally, workplace supports to build capacity for team-based care practices, collegial support in problem-solving and opportunities for 'connecting' with LTC nursing colleagues would be beneficial. Our findings suggest a role for professional development resources in the workplace that could help rebuild this workforce and support RPNs in providing quality care for older adults living in LTC. PATIENT OR PUBLIC CONTRIBUTION: Our research team included two members of the Registered Practical Nurses Association of Ontario, and these team members contributed to the discussion and design of the study methodology, recruitment, analysis and interpretation. Further, RPNs working in long-term care during the COVID-19 pandemic were the participants in this study and, therefore, contributed to the data. They did not contribute to data analysis or interpretation.

"Being" an Older Adult Skier: The Phenomenology of Masters Alpine Ski Racers.

This research examined the lived experience of older adult Alpine skiers in their continued participation in competitive ski racing. The aim was to gain an understanding of the meaning of the experiences for older adults as they continued to compete in Alpine ski racing. Masters skiers between the ages of 69 and 82 years participated in individual interviews. Data collection and analysis were iterative processes informed by phenomenological methods and visual mind mapping. The overarching theme identified in participants' accounts was the significance of the identity of "Being" a Ski Racer. Supporting subthemes were Enjoying the Feeling of Ski Racing, Adapting in the Sport, and Skiing as a Lifestyle. These insights offer the opportunity to encourage and support the holistic experiences of older adults who maintain their athletic identity as they age. This research highlights how inclusion of older adults' stories may foster critical reflexivity and challenge assumptions about aging.

Improving Family Presence in Long-Term Care during the COVID-19 Pandemic.

Family caregivers play a vital role in supporting the physical and mental health of long-term care (LTC) residents. Due to LTC visitor restrictions during the COVID-19 pandemic, residents (as well as family caregivers) showed significant adverse health outcomes due to a lack of family presence. To respond to these outcomes, eight implementation science teams led research projects in conjunction with Canadian LTC homes to promote the implementation of interventions to improve family presence. Overall, technological and virtual innovations, increased funding to the sector and partnerships with family caregivers were deemed effective methods to promote stronger family presence within LTC.

Exploring the Experience of Exercise in Older Adults With Chronic Back Pain.

Physical inactivity and chronic back pain are prevalent among older adults; however, there are individuals who persist in exercising despite daily pain. This research explored the meaning of exercise in the lives of older adults with chronic back pain. Hermeneutic phenomenology, valuing everyday experiences and highlighting meaning, was employed. Individual in-depth interviews with 10 adults aged 65 years and older gathered rich descriptions of their experiences. Data collection and analyses were iterative processes. The experience of exercise was inextricably connected with older adults' chronic back pain. The essence of embodied relief from pain offered by exercise was considered through themes reflecting the restoration of existential coherence-enjoying exercise experiences, social engagement, gratitude, learned latitudes, maintaining mobility, and aging. Understanding that older adults can live in their bodies pain-free for some time with regular physical activity may endorse adherence to exercise participation for maintained or improved well-being.

Enacting Fall Prevention in Community Outreach Care.

Despite increased international concern about fall prevention throughout the past 20 years, only limited attention has been paid to the experiences and perspectives of health care providers who deliver fall prevention programs. The purpose of this interpretive phenomenological study was to explore the meaning of the experience of enacting fall prevention, through individual semistructured interviews, among 6 members of an interprofessional geriatric outreach team in Ontario, Canada. Findings suggest that enacting careful practice was essential to the experience of enacting fall prevention, represented by four interrelated phenomenological themes: caring fully for older clients, carefully seeing older clients in their life contexts, enacting therapeutic relationships, and experiential learning in interprofessional teams. We discuss findings in relation to literature on emotional labor, leading to suggestions for the policy and practice of fall prevention.

Educators' Perspectives on the Teaching and Learning of Type 2 Diabetes Content in Physiotherapy Programmes across Canada.

Purpose: This qualitative descriptive study researched educators' perspectives of type 2 diabetes (T2D) Teaching and learning, in physiotherapy (PT) programmes across Canada. Methods: Faculty members and clinical instructors from the 15 PT programmes in Canada were contacted. Online surveys collected data on the educators' professional background and perspectives on T2D in the PT curriculum. One-on-one telephone interviews were conducted and thematic analysis was used to generate themes and codes from the interview transcripts. Results: Ten educators from 10 universities completed the survey. Seven of the 10 educators also participated in a telephone interview. Survey responses revealed that T2D content is taught predominantly through case studies and lectures. Of the 10 respondents, six reported that the curriculum does not devote adequate time to T2D content, and nine reported they "strongly agree" or "agree" that T2D is an essential component of the PT curriculum. The interviews revealed that T2D content varies across PT programmes. The educators agreed that T2D is a common condition seen in practice, there is a role for PT intervention, and T2D content is limited by classroom time. Conclusions: Educators noted challenges integrating more T2D content in the curriculum and said that PT clinical contributions for people living with T2D are underutilized. Additional evidence-informed rationale is needed to explore optimal integration of T2D content in PT programmes.

Objectif: étude descriptive qualitative sur le point de vue des éducateurs à l'égard de l'enseignement et de l'apprentissage sur le diabète de type 2 (DT2) dans les programmes de physiothérapie du Canada. Méthodologie: prise de contact avec les professeurs et éducateurs cliniques de 15 programmes de physiothérapie au Canada. Au moyen de sondages en ligne, les chercheurs ont recueilli des données sur l'expérience professionnelle des éducateurs et leurs points de vue au sujet du DT2 dans le programme de physiothérapie. Ils ont réalisé des entrevues individuelles et procédé à une analyse thématique pour dégager des thèmes et des codes à partir des transcriptions d'entrevue. Résultats: dix éducateurs de dix universités ont rempli le sondage. Sept d'entre eux ont également participé à une entrevue téléphonique. Les réponses au sondage ont révélé que la matière sur le DT2 est surtout enseignée dans le cadre d'études de cas et d'exposés.Six des dix répondants ont déclaré que le programme ne prévoit pas assez de temps sur la matière liée au DT2 et neuf ont affirmé qu'ils étaient « fortement d'accord ¼ ou « d'accord ¼ avec le fait que le DT2 est un élément essentiel du programme de physiothérapie. Les entrevues ont révélé que la matière sur le DT2 varie selon les programmes. Les éducateurs ont convenu que le DT2 est une affection courante en pratique, qu'il y a un rôle pour une intervention en physiothérapie et que la matière sur le DT2 est limitée par le temps en classe. Conclusions: les éducateurs ont souligné les difficultés à intégrer plus de matière sur le DT2 au programme et ont affirmé que l'apport clinique est sous-utilisé en physiothérapie auprès des personnes qui vivent avec le DT2. Il faudra obtenir plus d'explications fondées sur des données probantes pour explorer la manière optimale d'intégrer de la matière sur le DT2 aux programmes de physiothérapie.

Bridging Educational Grant in Nursing (BEGIN) students' intentions for retention in long-term, home and community care: A survey protocol.

INTRODUCTION: Retention of nurses in long-term care (LTC) and home and community care (HCC) settings is a growing concern. Previous evidence underscores factors which contribute to nurses' intentions for retention in these sectors. However, perspectives of nursing students preparing to enter the workforce, and their intentions for short-term and long-term retention, remain unknown. This study aims to explore relationships between short-term and long-term intentions for retention with psychological empowerment, work engagement, career commitment, burnout, prosocial motivation, self-care and personal resilience among students enrolled in nursing educational bridging programs supported by the Bridging Educational Grant in Nursing (BEGIN) program in Ontario, Canada. METHODS AND ANALYSIS: This cross-sectional design study will use an open online survey to investigate perspectives of current nursing students enrolled in educational bridging programs on factors relating to psychological empowerment, work engagement, career commitment, resilience, burnout, prosocial motivation, self-care and intentions for retention. Additionally, the survey will collect demographic information, including age, gender, ethnicity, citizenship, income, family status, nursing role, and years of employment and/or education. Open-ended questions will elicit participants' perspectives on financial considerations for career planning and other factors impacting intentions for retention. Descriptive data will be presented for contextualisation of participants' demographic characteristics to enhance generalisability of the cohort. Descriptive statistics will be used to summarise participants' scores on various assessment measures, as well as their short-term and long-term intentions for retention in LTC and HCC after completion of BEGIN. A Pearson's product moment r correlation will determine relationships between intentions for retention and other measures, and linear regression will determine whether any potential correlations can be explained by regression. ETHICS AND DISSEMINATION: This research protocol received ethical approval from a research-intensive university research ethics board (#123211). Findings will be disseminated to nursing knowledge users in LTC and HCC through publications, conferences, social media and newsletters.

Work Disparities and the Health of Nurses in Long-Term Care: A Scoping Review.

Work disparities, such as unfairness in pay or unequal distribution of work experienced by nurses in long-term care (LTC), can impact the retention and health of this workforce. Background: Despite the significant impact of disparities on nurses' health in LTC, a literature review on work disparities of nurses in LTC has not been conducted. Method: This scoping review aimed to explore the nature and extent of research on meso-level work disparities experienced by nurses in LTC and its links with nurse health and well-being. Five databases were searched: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), SCOPUS, and CINAHL (EBSCO host). Results: Of the 5652 articles retrieved, 16 studies (14 quantitative and 2 qualitative) published between 1997 and 2024 met the inclusion criteria. A total of 53 work disparities were identified. Only four articles investigated the association of a work disparity with a variable of health (e.g., physical, mental, or poor general health). Conclusions: The results suggest that more attention to how disparities impact nurses' health and lived experiences is warranted. Meso-level disparities from this review provide an initial basis to consider possibilities in the workplace, especially in supporting equity and opportunities for health and well-being at work (e.g., through fair access to professional growth opportunities and a more equitable balance of work expectations and demands of nursing staff). Future studies of the intersection of macro- and meso-level factors are needed to inform better workplace practices and social and economic policies to support the well-being, health, and safety of nurses at work in LTC.

User experiences of older adults navigating an online database of community-based physical activity programs.

Objectives: This study aimed to (1) explore older adult user experiences navigating an online health database of local physical activity programs; (2) compare navigational feedback with age-friendly website design guidelines; (3) assess online database completeness. Methods: Focus groups, including guided tasks and a semi-structured interview script, gathered navigational user experiences of fifteen older adults. A review of the literature sought age-friendly best practice website design guidelines and a website search for local physical activity programs was completed. Results: The design of the online database website was challenging for older adult participants to navigate and was not 'intuitive'. Based on focus group feedback, there were multiple discrepancies between the evaluated online database and the established guidelines for designing age-friendly websites. A total of 187 physical activity programs were missing from the database. Conclusions: Findings provide novel insight into user experiences of older adults navigating online health and physical activity program sites. Redesigning the following age-friendly website recommendations would empower older adults in the use of online databases and promote awareness of local physical activity programs. Health care providers need reliable and age-friendly online resources to link their patients with local physical activity programs to promote healthy aging.

Assessing physical function after completing a supervised education and exercise program in adults with type 2 diabetes and exploring exercise motivation at one-year follow up: A case series study.

BACKGROUND: Exercise programs for adults with type 2 diabetes (T2D) improve glycemic control and physical function. However, diabetes complications, disability, and motivation pose challenges for exercise participation. OBJECTIVE: The purpose of the study was to: 1) measure change in fasting blood glucose, blood pressure, anthropometrics (i.e. BMI and waist circumference), and physical function (i.e. endurance, agility and balance, upper and lower-body strength and flexibility) after completing an eight-week education and exercise program for adults with T2D; and 2) explore the experience of exercise continuation in people living with T2D at one-year follow-up. METHODS: A mixed methods case series design was conducted. Participants were ≥ 18 years and had a clinical diagnosis of T2D (glycated hemoglobin (A1C) ≥ 6.5%). Participants completed two one-hour exercise sessions and one one-hour education session per week for eight weeks. Blood glucose, blood pressure, body mass index (BMI), waist circumference, and physical function were measured at baseline and after completing the program. Follow-up telephone interviews were conducted at one, six, and 12-months and thematic analysis was employed to analyze interviews. RESULTS: Twelve participants completed the program. Clinically significant improvements were observed for waist circumference, systolic blood pressure, six-minute walk test (6MWT), timed up-and-go test (TUG), 30-second chair stand test (CST) and arm curls. Three themes emerged from the interviews that described participant reflections and experiences with a supervised education and exercise program for management of their T2D: 1) medical management; 2) lifestyle management; and 3) finding what works. Conclusion: Supervised programming improves physical function and may mitigate disability. Physiotherapists are qualified to assess and treat physical function through education and exercise.

A Survey of Canadian Physiotherapists' and Physiotherapy Students' Knowledge and Use of Executive Functioning Assessments in Clinical Practice.

Purpose: This study examined what physiotherapists and physiotherapy students understand and know about executive functioning (EF), what EF outcome measures they use clinically, and whether their primary area of practice influences their assessment practices. Method: An open online survey was distributed to registered members of the Canadian Physiotherapy Association, its various divisions, and colleges of physiotherapy within Canada that took approximately 15 minutes to complete and was available for 13 months. Pearson correlation was used to assess the relationship between subjective and objective understanding and knowledge of EF (UKEF) and a one-way multivariate analysis of variance was used to analyze differences in survey responses based on respondents' primary area of practice. Results: A total of 335 respondents consented to participate (completion rate = 78.4%). There was a significant moderate positive correlation between subjective and objective UKEF (r = 0.43; 95% CI: 0.32, 0.54; n = 260; p < 0.001). Significant differences in survey responses were related to physiotherapists' primary areas of practice (i.e., musculoskeletal, neurological, cardiorespiratory, or multi-systems; F12,555.89 = 2.29, p = 0.008; Wilks Λ = 0.880; partial η2 = 0.042). Conclusions: Respondents reported that they had good subjective UKEF, but this was only moderately correlated with objective UKEF.

Objectif : examiner ce que les physiothérapeutes et les étudiants en physiothérapie comprennent et savent sur le fonctionnement exécutif (FE), les mesures de résultats du FE qu'ils utilisent en clinique et si leur secteur primaire de pratique influe sur leurs pratiques d'évaluation. Méthodologie : les membres de l'Association canadienne de physiothérapie, ses diverses divisions et les ordres de physiothérapie du Canada ont reçu un sondage en ligne ouvert qui exigeait une quinzaine de minutes de leur temps et qui était disponible sur une période de 13 mois. Les chercheurs ont utilisé la corrélation de Pearson pour évaluer la relation entre la compréhension et les connaissances subjectives et objectives du FE (CCEF) et une analyse de variance multivariée unidirectionnelle pour analyser les différences entre les réponses au sondage d'après les secteurs primaires de pratique des répondants. Résultats : Au total, 335 répondants ont consenti à participer (taux d'achèvement = 78,4 %). Ils ont constaté une corrélation positive modérée significative entre les CCEF subjectives et objectives (r = 0,43; IC à 95 % : 0,32, 0,54; n = 260; p < 0,001). Des différences significatives dans les réponses au sondage étaient liées aux secteurs primaires de pratique des physiothérapeutes (musculosquelettique, neurologique, cardiorespiratoire ou multisystémique; F12,555,89 = 2,29; p = 0,008; Λ de Wilks = 0,880; η2 partiel = 0,042). Conclusions : les répondants ont déclaré qu'ils avaient de bonnes CCEF, mais leur réponse était seulement corrélée modérément avec les CCEF objectives.

Web-Based Presence for Social Connectedness in Long-Term Care: Protocol for a Qualitative Multimethods Study.

BACKGROUND: The COVID-19 pandemic and resultant restrictions on social gatherings significantly impacted many peoples' sense of social connectedness, defined as an individual's subjective sense of having close relationships with others. Older adults living in long-term care homes (LTCHs) experienced extreme restrictions on social gatherings, which negatively impacted their physical and mental health as well as the health and well-being of their family caregivers. Their experiences highlighted the need to reconceptualize social connectedness. In particular, the pandemic highlighted the need to explore novel ways to attain fulfilling relationships with others in the absence of physical gatherings such as through the use of a hybridized system of web-based and in-person presence. OBJECTIVE: Given the potential benefits and challenges of web-based presence technology within LTCHs, the proposed research objectives are to (1) explore experiences regarding the use of web-based presence technology (WPT) in support of social connectedness between older adults in LTCHs and their family members, and (2) identify the contextual factors that must be addressed for successful WPT implementation within LTCHs. METHODS: This study will take place in south western Ontario, Canada, and be guided by a qualitative multimethod research design conducted in three stages: (1) qualitive description with in-depth qualitative interviews guided by the Technology Acceptance Model (TAM) and analyzed using content analysis; (2) qualitative description and document analysis methodologies, informed by content and thematic analysis methods; and (3) explicit between-methods triangulation of study findings from stages 1 and 2, interpretation of findings and development of a guiding framework for technology implementation within LTCHs. Using a purposeful, maximum variation sampling approach, stage 1 will involve recruiting approximately 45 participants comprising a range of older adults, family members (30 participants) and staff (15 participants) within several LTCH settings. In stage 2, theoretical sampling will be used to recruit key LTCH stakeholders (directors, administrators, and IT support). In stage 3, the findings from stages 1 and 2 will be triangulated and interpreted to develop a working framework for WPT usage within LTCHs. RESULTS: Data collection will begin in fall 2023. The findings emerging from this study will provide insights and understanding about how the factors, barriers, and facilitators to embedding and spreading WPT in LTCHs may benefit or negatively impact older adults in LTCHs, family caregivers, and staff and administrators of LTCHs. CONCLUSIONS: The results of this research study will provide a greater understanding of potential approaches that could be used to successfully integrate WPTs in LTCHs. Additionally, benefits as well as challenges for older adults in LTCHs, family caregivers, and staff and administrators of LTCHs will be identified. These findings will help increase knowledge and understanding of how WPT may be used to support social connectedness between older adults in LTCHs and their family members. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50137.

Implementation and impacts of virtual team-based care planning for older persons in formal care settings: A scoping review.

Objective: This scoping review aimed to summarize current knowledge about the implementation, impacts, facilitators and barriers of virtual team-based care planning for older persons in formal care settings (e.g. home and community, primary, long-term and acute care). Methods: The Joanna Briggs Institute (JBI) methodology was used. The Arksey and O'Malley and Levac, Colquhoun, and O'Brien methodologies provided additional frameworks. Databases accessed included PubMed, EMBASE, CINAHL, AgeLine, PsycInfo and Scopus. Reference lists of selected articles and grey literature retrieved through Google and Google Scholar were also reviewed. Three researchers screened titles, abstracts and conducted full-text reviews. Extracted data were mapped in a table and analysed for summative themes. Older persons and family partners assisted in interpreting findings based on their lived experiences. Results: A total of 27 studies were included. Virtual team-based care planning led to many positive outcomes for older persons (e.g. decreased depression, reduced falls and improved medication management) and their families (e.g. reduced caregiver stress and improved caregiving skills). Only four studies reported the involvement of older persons and/or families in virtual team-based care planning. Multiple barriers to adopting virtual team-based care planning were found including lack of education/training for older persons and families in using technology. Conclusion: Despite the multiple advantages that virtual team-based care planning offers for older persons and families, it is important to ensure that this care can be offered to all. There is a need to ensure that health equity is addressed to promote access to care and respond to social determinants of health.

The Role and Contributions of Nurses in Stroke Rehabilitation Units: An Integrative Review.

Nurses' contributions to stroke rehabilitation have been viewed as pivotal, but therapeutically nonspecific. This integrative review synthesized empirical literature on the roles and contributions of nurses to inpatient stroke rehabilitation to answer three research questions: (a) What specific skills or tasks have been identified as the roles and contributions of nurses to inpatient stroke rehabilitation? (b) How do nurses perform these skills/tasks to support and promote inpatient stroke rehabilitation and recovery? and (c) What factors have been identified to impact nurses' working conditions on inpatient stroke rehabilitation units? A systematic search of multiple electronic databases retrieved seven studies which provided significant context and examples to these questions. What nurses do in practice included, for example, maximizing patients' independence in performing daily activities, preventing harm, and preserving integrity. How nurses perform their therapeutic roles included teaching, coaching, coordination, management, advocacy, collaboration. Factors that impact nurses' working conditions consisted of time, resources, and knowledge. This review demonstrates our current understanding of nurses' contributions to inpatient stroke rehabilitation, highlights their significant role, identifies current barriers/challenges of implementing stroke nursing care, and suggests ways of documenting and measuring nurses' contributions.