Browsing by Author "Moules, Nancy"
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- ItemOpen AccessBelonging, Becoming, and the Female Body: A Phenomenological Hermeneutic Inquiry into Overweight Women's Experience of Belonging in Western Contexts(2017) Beierling, Susan Patricia; Field, James; Moules, Nancy; Laing, CatherineThe purpose of this study, which utilized a phenomenological hermeneutic methodological framework, was to gain a deeper understanding, through the lived experience of self-proclaimed overweight women, of the sense of belonging. Five middle-aged women participants participated in group gatherings as well as one-on-one interviews with the researcher, where the experience of belonging was the central focus. The data was then analyzed via an hermeneutic framework guided by Hans-Georg Gadamer’s philosophical hermeneutics. Findings from this research revealed that overweight women face some powerful tensions as they come to terms with their growing bodies. An exploration of language and dominant discourses presented diverse and disparate meanings of specific words as well as grand ideals. Borrowing from van Manen’s work, four lived existentials (lived space, lived, time, lived body, and lived relation) are explored in a form of interpretation to gain deeper understanding of one participant’s words. Stigma and shame are explored, leading to the suggestion that living under a highly negative stigma can lead to a form of embodied shame (Bouson, 2009). Heidegger’s notions of homelessness, abiding, and homecoming are considered in coming to better understand the experience of moving between belonging and not, as the participants’ bodies became factors that cast them from their familiar lives into a form of abiding homelessness, in which each participant has had to find her own way. More conversations with and between like and different individuals, I conclude, are necessary in breaking through silences and allow for deeper understanding of self and other. Additionally, this research speaks to the need to draw attention to the grand narratives, and to explore and listen to other, non-dominant, and perhaps, more meaningful discourses.
- ItemOpen AccessCo-Constructing COVID-19: Learning Relational Practices From Families Facing a Global Pandemic(2024-07-05) Stone, Jezzamyn Malia; Mudry, Tanya; Mendaglio, Salvatore; Moules, NancyDuring the coronavirus (COVID-19) pandemic, families around the world experienced a cascade of unanticipated changes to their daily living. The effects of a disaster event, such as a pandemic, can contribute to a decline in mental and/or relational health, and the family system has the potential to promote recovery and resilience by buffering such risks. Despite the surge of research on the pandemic since 2020, much of the literature about disaster events (the pandemic included) tend to focus on the individual, lacking representation of the family system. In addition, practical resources targeting post-disaster recovery is limited, including guidance for families and mental health practitioners who support families. The purpose of this research was to: (a) better understand families’ relational experiences during the COVID-19 pandemic by nature of their interpersonal patterns; (b) expand the empirical representation of pragmatic, family-focused research on natural disasters from a systems and social constructionist lens; and (c) disseminate practical knowledge, information, and resources to support family recovery and therapeutic intervention following disaster. I conducted virtual, multi-member family interviews with six families from Calgary, Alberta, Canada and surrounding areas within the first year of the pandemic. Drawing from family systems theory and social constructionism, I integrated the IPscope, a family therapy tool for assessment and intervention, with interpretive description as a method for data construction and analysis. Based on the findings, I constructed two conceptual models of families’ interpersonal patterns during the pandemic that demonstrate the benefits of the family system in navigating a disaster event.
- ItemOpen AccessEmerging Horizons: Crafting Meaning and Cultivating Understanding Through Digital Storytelling(2021-11-02) Lang, Michael James; Laing, Catherine; Moules, Nancy; McLeod, DeborahAdolescent and young adults (AYA) are a distinct sub-population in oncology with unique needs and a high risk of long-term psychosocial distress. However, few age-appropriate psychosocial interventions for this population have been developed. Digital Storytelling (DST) is a multimedia production methodology that uses images, videos, a voiceover, and various video editing techniques to convey an important story in a short, three-to-four-minute film. The characteristics of DST suggest it could help AYA cancer survivors to craft and share their cancer story in a way that enhances psychosocial health. The purpose of this philosophical hermeneutic inquiry was to understand the DST experiences of AYA cancer survivors. Six AYAs were invited to participate in a DST workshop that was filmed and crafted into a documentary film called Emerging Horizons. The AYAs were interviewed before, during, and after the workshop with both the interviews and the film being analysed to bring understanding to the topic. Findings from this research revealed that the storying/re-storying process of DST provided AYAs the opportunity to craft meaning from their cancer experience and cultivate a deeper understanding of the life lessons embedded in it. Some specific findings included DST as a means to (a) stop and reflect on the inner emotional experience of cancer, (b) use more than words to convey the cancer experience, (c) leverage the possibilities of a co-creative space to gain deeper understanding, (d) provide direction for a future self, and (e) challenge culturally acceptable cancer narratives. Findings also elucidated the suitability of DST across the AYA cancer survivorship trajectory, identified hermeneutic philosophy as a strong philosophical foundation for DST praxis, and highlighted the opportunities of DST and documentary filmmaking in health research. DST, I conclude, is an age-appropriate intervention for AYAs and, in the right context and setting, can support AYAs to incorporate a cancer experience into their developing identity. The in-depth understanding of the DST experiences of AYAs provided through both the film and written interpretations in this study will enable future DST research with AYAs and across other healthcare populations and contexts.
- ItemOpen AccessExploring Undergraduate Nursing Students' Experiences of End-of-Life Conversations(2022-10-18) D'Souza, Cheryl; Laing, Catherine; Raffin-Bouchal, Shelley; Moules, NancyNurses report that communicating with patients and families about End of Life (EOL) issues is one of the most challenging aspects of providing EOL care. Many nurses enter practice not feeling prepared or confident to talk about death and dying, and research related to how student nurses encounter EOL conversations in their practicums is lacking. We investigated final year undergraduate nursing students’ experiences of having EOL conversations with patients and family members in their clinical settings. Semi-structured interviews were conducted and analysed using Braun and Clark’s (2006) framework of thematic analysis (TA). A total of five participant interviews were conducted and analysed to yield the following four themes: attitudes towards death and death talk; nursing students’ inner world during EOL conversations; recognizing, communicating, and responding to patients; and the student nurse role in EOL conversations. For nursing students, engaging in EOL conversations with patients and their families is experienced as a complex intellectual and emotional process. Students often fear saying the wrong thing and feel uncertain in knowing how to navigate these conversations. Implications for practice include addressing the gaps in EOL communication content and training in the nursing programs.
- ItemOpen AccessHe Seemed Like Such a Nice Guy: Young Adults' Understandings of Intimate Partner Violence(2016) Corcoran, Lynn Ann; Kawalilak, Colleen; Bohac-Clarke, Veronika; Moules, Nancy; McCaffrey, Graham; Charles, GrantIntimate partner violence is a serious concern with consequences related to physical, social, and emotional health of individuals, families, and society. Despite extensive research and targeted strategies to address this problem, incidents of intimate partner violence occur while local, provincial, and national agencies track this violence over time. Emerging adults are in a life stage where they are forming beliefs about intimate partner relationships. They are engaged in adult learning that occurs incidentally as they navigate experiences in life, work, and love. As such, they are in a position to contribute to an understanding of the range of intimate partner relationships (healthy, unhealthy, and violent) with the possibility of informing strategies aimed at preventing this violence. In light of the magnitude of the concern of intimate partner violence, I conducted a study using hermeneutics as a philosophy and method to explore how emerging adults understand violence in relationships. Data sources included unstructured interviews with 12 individuals aged 18 to 29 years and media reports of a critical incident of intimate partner violence wherein four young people were shot by an ex-boyfriend of one of the young adults before he shot himself. Findings included: the importance of being connected to friends and not isolating oneself; the existence of sexual pressure and issues of ambiguity regarding consent to sexual activity; the challenge of recognizing violence in relationships and the stigma that goes with labelling it as such; the influence of media reports of intimate partner violence, in particular the use of the rhetoric of he seemed like such a nice guy; the powerful impact that texting has in communication between emerging adults in intimate partner relationships and its connection to stalking and jealousy; and the protective effect of loving family and friends on young people as they navigate intimate partner relationships. Implications of this study include the possibility of multiple strategies for prevention of intimate partner violence situated in adult learning. These strategies include utilizing the voices of emerging adults to reflect the challenge of recognizing and naming violence in relationships to make a powerful impact on cognitive and emotional levels.
- ItemOpen AccessHead and Neck Cancer Survivors' Exercise Preferences and Barriers Before and After Participation in an Exercise Intervention(2016) Jackson, Colleen; Culos-Reed, S. Nicole; Lau, Harold; Bridel, William; Pelletier, Guy; Moules, NancyPurpose: This study examined the exercise preferences and barriers of head and neck cancer (HNC) survivors in relation to exercise experience. Methodology: Participants from the ENHANCE trial (n=22) completed questionnaires on exercise preferences and barriers, which were further explored in semi-structured interviews with a subset of participants (n=17). Results: Before participation in the ENHANCE program, lack of interest and time were the primary exercise barriers. After participation, there was a significant decrease in typical barriers including lack of interest (p=.008)), exercise not a priority (p=.039), and not in routine (p=.004). Participants also reported significant increases in preferences for engaging in exercise at a cancer centre (p=.031), and with other survivors (p=.016). Four higher-order themes emerged from interview data analysis pertaining to preferences (exercise types, company, supervision, and logistics), and three higher-order themes regarding barriers (physical, psychological and external). Significance: The results identify key factors for effective HNC exercise program design.
- ItemOpen AccessInpatient Pediatric Oncology Nursing Adolescent Relational Care: It is Different, the Difference, and Making a Difference(2017) Toner, Nicole; Moules, Nancy; Tapp, Dianne; Wulff, DanielAdolescents diagnosed with cancer confront a unique set of psychosocial challenges related to their particular developmental stage. Adolescents have high rates of psychosocial distress at diagnosis and their distress rates remain high well into survivorship. A nurse’s knowledge and sensitivity to the unique intersection between adolescent development and having cancer is foundational to effective psychosocial care. Responsive relationships between adolescents and nurses may well ease the distress of being hospitalized for cancer treatment and mitigate the various unique psychosocial sequela that cancer has on the adolescent developing self. Very little research has been done to understand the experience and meaning of the relationships developed between inpatient pediatric oncology nurses and their adolescent cancer patients. My purpose in this philosophical hermeneutic inquiry was to better understand the experience of relationship between adolescents with cancer and pediatric oncology nurses on pediatric oncology inpatient units, from both nurse and patient perspectives. Eight participants who have or had cancer during adolescence (14-18 years of age) and four pediatric oncology nurses were interviewed with an intent to expand the meaning of this relationship as it applies to practice. These data were then analyzed according to hermeneutic tradition as guided by the philosophical hermeneutics of Hans-Georg Gadamer. Findings from this research revealed that adolescent needs are distinctive and important just because of their difference. Friendship-like adolescent-pediatric oncology nurse relationships on inpatient units are pivotal to a positive and developmentally constructive hospital experience. Developmentally appropriate relational nursing care includes: humor, social connection, “real speak,” being “rounded up” or treated older than chronological age, and friendship. The findings support the idea that friend-like relationships developed between nurses and adolescents are developmentally beneficial to the developing self and facilitate the integration of an adolescents pre-and-post cancer identity. Developmentally appropriate relational care of adolescents hospitalized for cancer on pediatric oncology units, I conclude, should be thought of as a psychosocial intervention in and of itself. Nurse-adolescent relationships are key to positive adolescent development in pediatric oncology inpatient care. The findings of this study underscore the need for future research that further understands the ways in which the inpatient pediatric oncology nurse-adolescent relationship may be therapeutic and the ways in which it is not.
- ItemEmbargoInvestigating the Interprofessional Socialization of Healthcare Educators Following an Interprofessional Simulation Facilitator Training Program: A Mixed Methods Study(2024-06-05) Dolan, Sara; Nowell, Lorelli; Moules, Nancy; Brockway, MeredithBackground: Patient safety incidents due to poor interprofessional collaboration have devastating impacts on patients and their families. Interprofessional socialization can lead to interprofessional collaboration. Interprofessional education is one method used to promote interprofessional socialization. Healthcare educators in the practice setting are tasked with delivering interprofessional education; however, they require specialized skills and interprofessional connections to effectively facilitate interprofessional learning. Although there is literature discussing the interprofessional socialization of students and frontline staff, there is a gap in the literature regarding the interprofessional socialization of healthcare educators in the practice setting. Purpose: The purpose of this research was to examine the experiences and perceptions of healthcare educators in the practice setting regarding interprofessional socialization following an interprofessional simulation facilitator training (SimSkills). Methods: I completed an explanatory sequential mixed methods study, including secondary data from program evaluation surveys (n = 87) and follow-up semi-structured interviews (n= 17), to examine participants perceptions and experiences of interprofessional socialization. In the first (quantitative) phase of the study, data were collected from the provincial simulation program, eSIM, in Alberta as part of an ongoing program evaluation. Attendees of the SimSkills program were invited to complete a retrospective pre-post program evaluation survey to evaluate their attitudes toward interprofessional socialization. In the second (qualitative) phase of the study, semi-structured interviews were conducted to explore the secondary data findings in greater depth. Descriptive and inferential statistics were used to analyze the quantitative data and qualitative data were analyzed using interpretive description. Integration occurred when quantitative data were used to inform the interview guide and qualitative data were used to explain quantitative results. Results: There was a statistically significant increase in the attitude toward interprofessional socialization following the training. Qualitative findings revealed five themes regarding interprofessional socialization: (a) benefits gained through interprofessional socialization, (b) interprofessional, uniprofessional, or both (dual identity), (c) facilitators to interprofessional socialization, (d) barriers to interprofessional socialization, and (f) opportunities to strengthen interprofessional socialization. Conclusion: Healthcare educators have positive views of interprofessional socialization; however, interprofessional socialization behaviors are inconsistent with interprofessional socialization behaviors across settings. Interprofessional learning opportunities may enhance interprofessional socialization among healthcare educators.
- ItemOpen Access“It’s not just camp”: Understanding the Meaning of Children’s Cancer Camps for Children and Families(2013-02-25) Laing, Catherine Mohrea; Moules, NancyIn response to the stress of the childhood cancer experience, children’s cancer camps arose in the 1970s as a way for children and their families to escape the rigidity and severity of cancer treatment. Cancer camps are designed to meet the needs of the whole family at each stage in the cancer experience—from diagnosis through treatment, to survival or bereavement. In 2008, the eight camps across Canada provided specialized oncology camps and community support programs to 5,252 children and their families – a 10% increase from the previous three years. As more children are surviving childhood cancer, the need for specialized camps and community programs continues to grow. My purpose in this philosophical hermeneutic inquiry was to understand the meaning of children’s cancer camps for the child with cancer and the family. Six childhood cancer families and five cancer camp counselors were interviewed in order to bring understanding to this topic. Findings from this research revealed that camp means different things for different families, and that much is at play in the cancer camp experience: finding acceptance and fit, grief as something to live with versus “get over,” storytelling as a means of re-shaping and understanding traumatic experiences, and the solidarity of the community as one that creates intense, healing bonds. Children’s cancer camps, I conclude, need to be considered a necessity, versus a luxury, and should even be thought of as a psychosocial intervention for some children and families. Barriers such as structure of funding and access to resources are present, and likely due to the separate-ness of camps from hospital programs. In addition, this research speaks to the need for interpretive methods like hermeneutics to incorporate a tool such as Social Return on Investment, a principles-based approach that values change that would not otherwise be valued, when questions of social value are present.
- ItemOpen AccessLike Mother, Like Daughter? Understanding Maternal Experiences of Intending to End the Intergenerational Transmission of Body Dissatisfaction to Daughters(2024-03-08) Brun, Isabel; Russell-Mayhew, Michelle; Mudry, Tanya; Moules, Nancy; Laing, Catherine; Grimwood, TomAddressing a critical gap in existing literature, this study ventures into the relatively unexplored domain of mothers' experiences of intending to prevent the passing of body dissatisfaction to daughters. In a society where thinness is often idealized, this research underscores the critical need to delve into the complex and nuanced experiences of mothers endeavouring to cultivate healthier body image for their daughters. Utilizing hermeneutic research methods, in-depth interviews were conducted with seven mothers, each navigating their own struggles with body image while being fiercely determined to protect their daughters from similar challenges. This study sought to understand the varied experiences of these mothers, exploring both the hurdles they faced and the triumphs they achieved. The findings illuminate the profound complexities inherent in the mother-daughter dynamic, particularly under the weight of societal expectations regarding body image. The insights gleaned from participant interviews underscore an urgent call for robust support systems for these mothers. Drawing upon the methodologies of Feminist Therapy, Narrative Therapy, Acceptance and Commitment Therapy, as well as family therapy, the findings of this study suggest a comprehensive approach, providing mothers with vital tools and psychological support. The suggested strategies are designed to empower mothers to effectively tackle their own body image concerns, while simultaneously shaping their daughters' attitudes and perceptions about their bodies. Moreover, this research envisions broader societal implications—paving the way for a new societal norm that embraces diverse body images and ideals. Altogether, the findings of this research transcend the realms of academia, offering significant insights for both ongoing research and clinical practice. This study highlights the imperative for tailored strategies and interventions that enable mothers to disrupt the cycle of intergenerational body dissatisfaction. Serving as a rallying cry for a more profound, empathetic understanding and fostering of healthier body images across generations, this research spotlights the crucial role of mothers in forging a future where body satisfaction is celebrated and normalized.
- ItemOpen AccessMore than Just Great Quotes: An Introduction to the Canadian Tri-Council’s Qualitative Requirements(2013-01-01) Boffa, Jody; Moules, Nancy; Mayan, Maria; Cowie, Robert LAlthough at times misunderstood by the general research community, qualitative research has developed out of diverse, rich and complex philosophical traditions and theoretical paradigms. In the most recent Canadian Tri-Council policy statement on the ethical conduct of research involving humans, a chapter was devoted to a summary of methods and methodological requirements that characterize robust qualitative research, despite the diversity of approaches. To dispel common misperceptions about qualitative research and introduce the unfamiliar reader to these requirements, the work of a qualitative study on isoniazid preventive therapy for prophylaxis of tuberculosis published in AIDS is critiqued alongside each of the Tri-Council’s nine requirements.
- ItemOpen AccessResonant Disruptions: Understanding Nurses’ Practice with Youth Survivors of Sexual Exploitation(2022-10-19) Giebelhaus, Danielle Erinn; Estefan, Andrew; Moules, Nancy; Walsh, ChristineThe sexual exploitation of youth is a global and local concern. Youth survivors of sexual exploitation often present to and require healthcare services but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this thesis, I report on a study undertaken using philosophical hermeneutics guided by the work of Hans-Georg Gadamer and other contemporary hermeneutic theorists. Hermeneutics is a useful way to conduct research when little is known about a topic. I ask the research question, “How might we understand nurses’ experiences of working with youth survivors of sexual exploitation?” In hermeneutic research, interpretations provide the basis for answering the research question. Three interpretations are discussed in this study: stigma, refuge, and beautiful words; how to convey mattering to youth survivors of SE; and what nurses hold onto for themselves and their patients. The findings point to an increase in understanding of nursing experience, and to clear need for increased training for nurses and other healthcare professionals.
- ItemOpen AccessUnable To Feed My Hungry Child: A Narrative Inquiry into the Experience of Caring for a Child with Prader Willi Syndrome(2022-12-22) Currie, Margaret Genevieve; Estefan, Andrew; Estefan, Andrew; Caine, Vera; Moules, Nancy; Dimitropoulos, Georgina; Bengezen, VivianePrader-Willi syndrome is a genetic disorder that causes insatiable hunger and overeating. It poses both significant health risks and complex social challenges for families. The experiences of mothers caring for a child with Prader Willi syndrome and managing the hyperphagia and anxiety are not well known. Researchers have studied the biological make up of Prader Willi syndrome but few have explored mothers’ experiences in managing the physical and mental health issues of caring for a child with hyperphagia, anxiety, and insatiation. This study is a narrative inquiry into the experiences of four mothers caring for their children with Prader Willi syndrome. Narrative inquiry is the study of experience using storied accounts and attends to the dimensions of temporality, place, and sociality. Four narrative accounts were co-composed with participants and highlight the complex political and social landscapes for families. The narrative accounts revealed two narrative threads, engaging in (extra)ordinary care practices, and navigating tensions called forth by coherent and incoherent stories. Recommendations for practice, policy, and theory are also presented after inquiring into mothers’ experiences.
- ItemOpen AccessUnderstanding Parents’ Experiences of Having a Child Survive a Malignant Pediatric Brain Tumour: A Philosophical Hermeneutic Inquiry(2022-06) Francois, Kaitlyn Dawn; Moules, Nancy; Estefan, Andrew; Laing, CatherineImprovements in the treatment of pediatric cancers, including malignant brain tumours, has resulted in more children surviving this illness well into their adolescent and adult years. It is widely known that survivors of brain tumours often experience long-term side effects of cancer treatments and/or the disease itself. These long-term effects often impact the survivor’s physical, psychological, or social wellbeing and can present significant challenges for the individual as well as for their family. Research on the experience of parents following treatment for their child’s malignant brain tumour is more limited, despite many parents being a central caregiver and source of support in the survivor’s life. The goal of this hermeneutic inquiry was to better understand parents’ experiences of having a child survive a malignant pediatric brain tumour, how interactions with the health care system have shaped the child and family’s experience, and how the survivorship experience can be improved for patients and their families. Semi-structured interviews were conducted with the parents of seven pediatric brain tumour survivors (PBTS) to inform understanding of the topic. Data were analyzed in hermeneutic research tradition, as influenced by the philosophical hermeneutics of Hans-Georg Gadamer. Findings revealed that, (a) survivorship was an enduring event and one that defined many aspects of parents’ lives, including daily routines and plans for the future, (b) parents struggled to achieve a balance between independence and dependence, especially for survivors who were more severely affected by cognitive, psychosocial, and emotional side effects, (c) survivors and parents felt left behind by multiple systems including health care and education, as well as by peers and in other relationships, (d) parents experienced a repetitive, cyclical nature to survivorship, described as being “frozen in time,” and (e) survivorship was a period of time wrought by emotion, with guilt, regret, and remorse being highlighted. For parents of PBTS, survivorship is highly complex, emotional, and cannot be navigated in isolation. It is expected that the in-depth understanding of parents’ experiences provided through the written interpretations in this study will lead to future research with families of PBTS and for other related populations and contexts.