Experience of childhood cancer: A narrative inquiry.

PURPOSE: To more fully understand the possible impact of childhood cancer on a young person's life through their own story. DESIGN AND METHODS: Using Connelly and Clandinin's narrative inquiry method, a participant named Noelle was engaged in a series of narrative interviews and a creative self-expression activity about her cancer experience when she was 12. Her story was examined through the three-dimensional space of experience (person, place, and time), and analyzed using Erikson's Psychosocial Stages of Development framework theoretical lens. RESULTS: Two significant narrative patterns emerged: identity and relationships. Although the physical effects of the cancer were successfully treated, the impact of this disease impacted Noelle's own psychosocial development as she was trying to evolve her relationships with peers and family, while grappling with her new identity as a cancer patient. PRACTICE IMPLICATIONS: Healthcare professionals need to intentionally increase their sensitivity to adolescent patients' lived experience of cancer. More specifically, there is a need for further education of healthcare professionals on the psychosocial impact of cancer in both the immediate and long-term trajectory of the cancer disease process.

Mothers Caring for Adult Children With Substance Use Disorder: Understanding Lived Experience.

BACKGROUND: Most persons with substance use disorder (SUD) live in family settings. In the absence of adequate mental health services, mothers are often called upon to provide care for their adult children with SUD. Despite positive outcomes such as decreased rates of hospitalization associated with family involvement, mothers are often stigmatized within the health care systems as contributors to trauma and/or family dysfunction. PURPOSE: The purpose of this study is to explore mothers' lived experience of caring for adult children with SUD. METHOD: Guided by critical feminist theory, this study used interpretive descriptive qualitative research design to identify patterns within mothers' experiences for practical relevance and application to service provision. RESULTS: The findings yielded in this study identified mothers' experiences as: longing for wellness, identity as loving mother, loss, anticipatory grief, shame and blame and feeling excluded from services. Ultimately, the findings from this study extend the limited research to date on mothers' experiences of stigma, especially when they are blamed for their child's illness. CONCLUSIONS: Findings from this study advocate for family-centered approaches that attend to mothers' unique experience, from their standpoint, and offer recommendations for change to service provision.

Understanding How Nursing Students Experience Becoming Relational Practitioners: A Narrative Inquiry.

BACKGROUND: Teaching nursing students to become relational practitioners requires theoretical approaches and strategies that engender personal and aesthetic knowing. These qualities closely parallel those that define relational practice. The use of creative self-expression in supporting the development of student capacity for relational practice offers a viable approach. PURPOSE: To learn how nursing students' engagement in creative self-expression activities may impact the construction of their professional identity and capacity for relational practice as novice nurses. METHOD: Clandinin and Connelly's narrative inquiry approach was used to explore nursing students' experiences of learning how to become relational practitioners. Four new nurse graduates engaged in a follow-up focus group using Schwind's narrative reflective process to discuss the impact of a relational practice workshop series. FINDINGS: Bronwyn's story became the composite of the four participants. Two key narrative patterns emerged: being in service of others and being knowledgeable collaborative leaders. These entailed an intentional engagement in relationships with patients, which required attention to the co-constructed relational space. The creative approaches used to facilitate students' learning informed their awareness that led to their transformation. IMPLICATIONS: Educating future nurses who are relational, person-centered practitioners requires a holistic approach to teaching/learning which also includes creative self-expression.

Exploring Undergraduate Nursing Students' Experiences of Engaging With a Dialectical Behavior Therapy-Skills Group Intervention: Findings of a Thematic Analysis.

STUDY BACKGROUND: Nursing students often have high levels of stress leading to negative consequences for academic performance and overall well-being. Novel strategies are needed to help students manage stress. PURPOSE: To explore students' experiences with an evidence-based intervention-Dialectical Behavior Therapy-Skills Group (DBT-SG). METHODS: We conducted a mixed-methods study to pilot test a DBT-SG intervention, modified for use with undergraduate nursing students. Qualitative data collected as part of this study included focus groups and written responses on a study questionnaire. Thematic analysis of these data was undertaken to explore how students experienced the intervention. The results of this analysis are reported here. RESULTS: Five themes were uncovered: experiencing stress and de-stressing, feeling accepted and validated, acquiring skills, shifting perspectives, and enhanced well-being. CONCLUSIONS: Our findings suggest that by engaging with DBT-SG, nursing students felt accepted and validated, acquired a variety of skills to cope with stress, as well as developed new perspectives, such as the value of practicing self-care, which contributed to enhanced well-being. Future research could build on these results by further exploring how to best create accepting and validating learning environments where students are encouraged to develop interpersonal relationship skills and enact self-care to further support their well-being and professional development.

Apoiando a educação em pesquisa dos graduandos de enfermagem / Apoyando la educación para la investigación de los estudiantes de enfermería de pregrado / Sustaining undergraduate nursing students' research education

Resumo Objetivos Descrever a experiência da implementação de um programa de treinamento de assistente de pesquisa voluntário para graduandos canadenses de Enfermagem, objetivando o desenvolvimento de habilidades de comunicação verbal e escrita, métodos de pesquisa e análise de dados, pensamento crítico e resolução de problemas, assim como o planejamento de suas carreiras e o avanço de seus papéis relacionados à pesquisa e às oportunidades administrativas e de liderança. Método Estudo descritivo com relato de experiência sobre o processo de treinamento para um novo papel profissional relativo ao engajamento dos graduandos em 11 oficinas, cada uma com duração de uma hora e o processo de apoiá-los para assumir papéis profissionais e de liderança. Resultados Os graduandos demonstraram comprometimento em todas as fases do treinamento. Destaca-se, ainda, o interesse por assumirem a liderança em atividades práticas que redefinem seu perfil profissional. Essa experiência contribuiu para construir e nutrir relações intelectuais docentes-graduandos. Os graduandos expandiram suas redes profissionais e a relação com o mentor de carreira, estão desenvolvendo suas habilidades práticas e relataram confiança em se candidatar para cargos de assistentes de pesquisa. Conclusão e implicações para a prática O treinamento pode instrumentalizá-los para escolhas de planos de carreira, ingresso no mercado de trabalho e a construção de plano para desenvolvimento profissional. O desejo genuíno dos docentes de Enfermagem, apoiando uma nova geração de enfermeiros, culminou nessa experiência de empoderamento mútuo.

Resumen Objetivos Informar sobre la experiencia de un equipo de profesionales de enfermería y desarrollo profesional en la implementación de un programa de asistente voluntario de investigación para estudiantes universitarios canadienses de pregrado en enfermería con el objetivo de desarrollar la comunicación escrita y verbal, métodos de investigación, análisis de datos, pensamiento crítico y habilidades de resolución de problemas, así como en su planificación y avance profesional para funciones relacionadas con la investigación y oportunidades de empleo administrativo y de liderazgo. Método Un diseño descriptivo con el informe de la experiencia de los investigadores de enfermería y desarrollo profesional sobre el proceso de apoyo para la formación de los estudiantes para un nuevo rol profesional. La experiencia se refiere a 11 talleres que durarán una hora sobre los temas relacionados con la investigación. Resultados Los estudiantes demostraron compromiso con la capacitación. Relevante es su interés en liderar actividades prácticas para redefinir su perfil profesional. Esta experiencia contribuyó a construir y fomentar relaciones significativas e intelectuales entre los profesores y los estudiantes. Los estudiantes amplían sus redes profesionales y obtienen una relación con un mentor de carrera. Conclusión e implicaciones para la práctica La capacitación puede equipar mejor a los estudiantes para elegir trayectorias profesionales, entrar en el mercado laboral y elaborar un plan para el avance profesional. Fue el deseo genuino de los profesores de enfermería de apoyar a una nueva generación de enfermeras que culminó en esta experiencia de empoderamiento mutuo.

Abstract Objective To describe the experience of implementing a research assistant program for Canadian undergraduate nursing students, which aimed to develop written and verbal communication, critical thinking and problem-solving skills, as well as knowledge of various research methods. Engagement in this program was intended to support students' career planning and advancement in research related roles, including administrative and leadership employment opportunities. Method A descriptive design with the report of experience of nursing researchers and career advisers pertaining to: engagement in an 11 one-hour research focused workshop; and the process of supporting students to assume professional and leadership roles. Results Students demonstrated commitment to the training program throughout its phases. They expressed interest in leading practical activities to redefine their professional profile. This experience contributed to building and nurturing intellectual teacher-student relationships. Students are expanding their professional networks and a relationship with a career mentor, while demystifying the research assistant role. Students are developing practical skills and reporting confidence in applying for research assistant positions. Conclusion and Implications for practice Participating in the training program better equips students for choosing their career path, entering the job market, and building a plan for further career advancement. Nursing faculty's genuine desire for and purposeful actions to support a new generation of nurses informed this mutually empowering experience.

Self-compassion in undergraduate nursing: an integrative review.

Objective To explore self-compassion and its role in supporting well-being, compassionate care, and the academic experience in undergraduate nursing students. Method Whittemore and Knafl's (2005) integrative review methodology was used to search articles published between 2007 and 2020, which resulted in 36 articles meeting the inclusion criteria: compassion for self and others, strategies to support self-compassion; and self-compassion and student learning. Result Findings indicate that self-compassion may promote compassionate care, personal well-being, resilience, and emotional intelligence while supporting indicators of academic success. Compassion literacy, mindfulness training, and experiential exercises are some of the strategies that could be integrated into nursing curricula to enhance compassion in nursing students for self and others. Conclusion Integrating mindfulness and self-compassion in undergraduate curricula requires innovative teaching and learning approaches within a supportive organizational environment. To this end, a Self-Compassion Curricular Model to guide nursing programs is proposed.

Decreasing stress and supporting emotional well-being among senior nursing students: A pilot test of an evidence-based intervention.

BACKGROUND: Nursing students can experience stress related to their academic and practice experiences, which can have deleterious effects on physical and emotional well-being. OBJECTIVES: To pilot test an evidence-based intervention, Dialectical Behavior Therapy-Skills Group, designed to promote emotional well-being among nursing students. DESIGN: A single group, pre-posttest design, mixed-method approach. SETTING: A large university situated in a multicultural urban setting. PARTICIPANTS: Senior undergraduate nursing students (n = 31). METHODS: Students participated in an 8-week modified Dialectical Behavior Therapy-Skills Group (DBT-SG) intervention. Quantitative and qualitative data were collected to explore the interventions' feasibility, acceptability, and students' perceptions of its applicability to practice. Students also completed standardized outcome measures of psychological distress and emotional well-being pre- and post-intervention to evaluate preliminary effectiveness. RESULTS: Overall feedback was positive, with participants describing how skill modules helped them establish relationships and manage stress in clinical, academic, and personal settings. Significant reductions in stress and improvements in well-being were also reported. CONCLUSION: Results suggest that DBT-SG offers a promising approach for mitigating nursing students' stress by helping them acquire practice-relevant strengths and self-care strategies. Further research is required to examine the effectiveness of DBT-SG among other nursing student groups, as well as to explore optimal approaches to delivering this intervention in conjunction with nursing curricula.

Mentors' and mentees' intellectual-partnership through the lens of the Transformative Learning Theory.

In this paper we report reflections about the scholarly mentoring experiences of undergraduate nursing students (mentees) and faculty members (mentors) involved in an intellectual partnership at a Canadian university. The paper specifically recounts the impacts of the transformative process experienced by 18 mentees and three mentors, based on their in-depth written critical reflections. In this collaborative initiative, the constructivist framework of Shor and Freire, and Mezirow's Transformative Learning Theory, served as foundations for all interactions between mentees and mentors, and guided the analysis and interpretation of their written self-reflections. Mentees and mentors were motivated by complementary goals for the intellectual relationships. Their combined contexts, self-reflective, critical dialogue, shared assumptions and ideas worked to ignite a critical awareness of their potential and self in their professional world. Sharing new ways of thinking and points of view stimulated their transformation on various levels -emotional, cognitive, and spiritual.

Mindfulness practice as a teaching-learning strategy in higher education: A qualitative exploratory pilot study.

BACKGROUND: Students in higher education are experiencing stress and anxiety, such that it impedes their academic success and personal wellbeing. Brief mindfulness meditation and lovingkindness meditation are two aspects of mindfulness practice that have the potential to decrease students' feelings of anxiety and stress, and increase their sense of wellbeing and capacity for compassion for self and for others. PURPOSE: To explore how undergraduate and graduate students experience brief instructor-guided mindfulness practice; specifically, on their feelings of stress and anxiety, and their sense of wellbeing. STUDY DESIGN: Qualitative exploratory pilot study. PARTICIPANTS AND SETTING: Fifty-two graduate and undergraduate students in different disciplines within a community services faculty of an urban university. METHODS: Brief (five-minute) instructor-guided mindfulness practices were offered over eight weeks at the beginning and end of classes. Participating students were asked to also engage in individual home practice of five to fifteen-minute mindful breathing four to five times a week and to keep a log of their experiences. At end of term, individual and group feedback (N=13) was elicited from participating students. Six of the seven instructors who guided the mindfulness practices shared their experiences of the mindfulness activities. OUTCOMES: Students reported an increased sense of calm, and a decreased feeling of anxiety. Lovingkindness meditation was mostly perceived as a positive way to close the class. Their instructors also observed that the brief mindful breathing practice at start of class helped students become more grounded and focused before engaging in the course content. Challenges encountered focused on the need to provide more in-depth information about mindfulness, as it relates to higher education teaching-learning contexts, to both students and participating instructors. CONCLUSIONS: Implications for education suggest further research that includes fuller experiential training of participating instructors, as well as provision of a more comprehensive background on mindfulness to students.

Development and Implementation of an Advanced Therapeutic Communication Course: An Interprofessional Collaboration.

BACKGROUND: Interprofessional education and practice have been gaining recognition during the past decade. However, little has been written on person-centered care (PCC) within interprofessional practice and how it could be taught to interprofessional learners. METHOD: A key element of PCC is therapeutic communication. Consequently, a group of interprofessional faculty innovated a graduate-level elective course on advanced therapeutic communication where interprofessional learners together explore PCC within interprofessional care. The course curriculum is underpinned by mindfulness in education, nonviolent communication, and reflective writing. Various teaching- learning strategies, including creative self-expression, are also used. RESULTS: The created competencies and conceptual framework may be used by other educators in creating a similar interprofessional course. Interprofessional learners gained a deeper and broader understanding of PCC in interprofessional care. CONCLUSION: On the basis of this undertaking, the faculty gained a deeper appreciation for interprofessional collaboration in the development of innovative educational methodologies that advance interprofessional teamwork in education and professional practice. [J Nurs Educ. 2016;55(10):592-597.].

Narrative Inquiry: Experience matters.

Narrative Inquiry is a research methodology that we adapted over the past two decades from Canadian higher education and curriculum studies to nursing research, education, and health-care practice. The Narrative Inquiry we use originated from Connelly and Clandinin in the 1990s, and rests on John Dewey's philosophy that experience is relational, temporal, and situational, and as such, if intentionally explored, has the potential to be educational. More specifically, it is only when experience is reflected upon and reconstructed that it has the potential to reveal the construction of identity, knowledge, and the humanness of care. Congruent with the expectation that nurses are reflective practitioners and knowledge-makers, Narrative Inquiry provides a means to enhance, not only quality of care, but quality of experience of those in our care: in education, our students, and in practice, our patients. In this article, we explicate how Narrative Inquiry may be lived in health-care education and practice, with a primary focus on nursing. We illuminate how we support our graduate students, the next generation of narrative inquirers, through a Narrative Inquiry Works-in-Progress group.

What can be learned from patient stories about living with the chronicity of heart illness? A narrative inquiry.

BACKGROUND: Patients' illness stories are valuable information that supports person-centred care across the illness trajectory. AIMS: To learn how older South Asian immigrant women experience living with heart illness long after discharge from hospital. METHOD: We used narrative inquiry, a personal experience method that explores and interprets lived and told stories through the three dimensions of experience. DESIGN: Four participants, over the age of sixty, living with heart illness for over ten years, were invited to engage in narrative interview and Narrative Reflective Process. OUTCOMES: Giving patients voice, allows caregivers insight into the human experience of illness beyond hospitalization. Considering the increased migration of people around the globe, this knowledge is significant in provision of person-centred care. IMPLICATIONS: Person-centred care does not end with the hospitalization and outpatient clinics. Inter-disciplinary teams need to reconsider the trajectory of chronic illnesses and the care required throughout, especially for marginalized populations.

The experience of developing a faculty research cluster using the creativity of the narrative reflective process.

Faculty development that builds research capacity is a significant yet challenging expectation in academia. The School of Nursing faculty at Ryerson University established several research clusters to support research collaborations and productivity. This article explicates one cluster's development process, and specifically, its adoption of the narrative reflective process (NRP). Engaging in NRP permitted the group to creatively enter into critical dialogue, address both individual and collective needs, and establish a supportive environment that nurtures the creative process--all of which ultimately enhances scholarship and academic productivity.

Fostering person-centered care among nursing students: creative pedagogical approaches to developing personal knowing.

Person-centered care (PCC) is grounded in principles of respect, autonomy, and empowerment and requires the development of interpersonal relationships. For nursing students to engage in PCC, they need to intentionally develop personal knowing, which is an essential attribute of therapeutic relationships. Developing personal knowing, as well as professional knowledge, positions students to enact PCC in their practice. Faculty members play a vital role in fostering the development of personal knowing by creating opportunities for students in which genuine and respectful dialogue, reflection, self-awareness, and critical thinking can take place. This article explores several creative approaches faculty have used to actualize these qualities in their teaching-learning encounters with nursing students at various stages of their students' professional development. These approaches offer experiential teaching-learning opportunities that foster the development of personal knowing, as well as constructive and respectful relationships between faculty and students, therefore laying the groundwork for PCC in practice settings.

Opening the black-box of person-centred care: An arts-informed narrative inquiry into mental health education and practice.

BACKGROUND: Nursing education has a history of encouraging students to know their patients and to negotiate the in-between of art/science, person/profession, and intuition/evidence. Nurse-teachers know that students may abandon some values and practices when they encounter practice environments that are complex and have competing agendas. We are concerned that nursing knowledge is black-boxed, invisible and taken-for-granted, in healthcare settings. OBJECTIVES: Our research explores how nursing students and nurses are constructing and enacting person-centred care in mental health education and practice. We want to understand the nursing standpoint on this significant ontological issue and to make nursing knowledge construction and utilization visible; illuminating how person-centred theory emerges from practice. DESIGN: The process involved four 3-hour group meetings and an individual follow-up telephone conversation. SETTINGS: Students and nurses met at a tertiary-care mental health organization. PARTICIPANTS: Fourteen nurses (Registered Nurses and Registered Practical Nurses) and nursing students (Bachelor of Science in Nursing and Practical Nursing) participated in our inquiry. METHODS: We used arts-informed narrative inquiry to explore experience through the arts such as metaphor, collage, poems, letters, and group conversations. RESULTS: The black-box is opened as the inquiry reveals how nursing knowledge is constructed, assumptions are challenged and new practices emerge. CONCLUSIONS: Our research is significant for education and for practice and is transferable to other populations and settings. Nurses are affirmed in person-centred values and practices that include partnership with those in their care, role modeling for colleagues and mentoring students and new nurses. Students participate in transferring their learning from school to practice, in the company of experienced colleagues; together they open the black-box to show how nurses conceptualize and enact person-centred care.

An international internship on social development led by Canadian nursing students: empowering learning.

BACKGROUND: A Canadian nursing student-led knowledge dissemination project on health promotion for social development was implemented with local professionals and communities in Brazil. OBJECTIVES: (a) to identify how student-interns contrasted Canadian and Brazilian cultural and social realities within a primary healthcare context from a social development perspective; (b) to examine how philosophical underpinnings, including social critical theory and notions of social justice, guided student-interns in acknowledging inequalities in primary healthcare in Brazil; and (c) to participate in the debate on the contribution of Canadian nursing students to the global movement for social development. DESIGN AND SETTING: A qualitative appraisal of short-term outcomes of an international internship in the cities of Birigui & Araçatuba (São Paulo-Brazil). PARTICIPANTS: Four Canadian fourth-year undergraduate nursing students enrolled in a metropolitan university program. METHODS: Recruitment was through an email invitation to the student-interns, who accepted, and signed informed consent forms. Their participation was unpaid and voluntary. One-time individual interviews were conducted at the end of their internships. Transcriptions of the audio-recorded interviews were coded using the qualitative software program ATLAS ti 6.0. The findings were analyzed using thematic analysis. RESULTS: Student-interns' learning unfolded from making associations among concepts, new ideas, and their previous experiences, leading to a personal transformation through which they established new conceptual and personal connections. The two main themes revealed by the thematic analysis were dichotomizing realities, that is, acknowledging the existence of "two sides of each situation," and discovering an unexpected reciprocity between global and urban health. Furthermore, the student-interns achieved personal and professional empowerment. CONCLUSIONS: The knowledge gained from the international experience helped the student-interns learn how to collaborate with Brazilian society's sectors to improve the social conditions of a "marginalized population". Student-interns became aware of their inner power to promote change by making invisible inequity visible in their own terms.

A cyborg ontology in health care: traversing into the liminal space between technology and person-centred practice.

Person-centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person-centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person-centred practice. Inspired by Haraway's work, we argue that healthcare practitioners who critically consider their cyborg ontology may begin the process to initiate and complicate the liminal and sought after space between technology and person-centred practice. In this paper, we draw upon Haraway's idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person-centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person-centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person-centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being.

Discussion of patient-centered care in health care organizations.

The tradition of inherent knowledge and power of health care providers stands in stark contrast to the principles of self-determination and patient participation in patient-centered care. At the organizational level, patient-centered care is a merging of patient education, self-care, and evidence-based models of practice and consists of 4 broad domains of intervention including communication, partnerships, health promotion, and physical care. As a result of the unexamined discourse of knowledge and power in health care, the possibilities of patient-centered care have not been fully achieved. In this article, we used a critical social theory lens to examine the discursive influence of power upon the integration of patient-centered care into health care organizations. We begin with an overview of patient-centered care, followed by a discussion of the various ways that it has been introduced into health care organizations. We proceed by deconstructing the inherent power and knowledge of health care providers and shed light on how these long-standing traditions have impeded the integration of patient-centered care. We conclude with a discussion of viable solutions that can be used to implement patient-centered care into health care organizations. This article presents a perspective through which the integration of patient-centered care into health organizations can be examined.