Browsing by Author "Page, Stacey"

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    Ethical Issues in Residency Education Related to the First Wave of the COVID-19 Pandemic: A Narrative Inquiry Study
    (2022-09) Kassam, Aliya; Mitchell, Ian; Page, Stacey; Lauzon, Julie
    Background: Around the world, the unprecedented COVID-19 pandemic has increased the demand for, and on, healthcare workers as it also continues to strain healthcare systems. Ethical issues that arise during pandemic health emergencies understandably impact such individuals as healthcare providers who have responsibilities to the public. Residency programs were faced with new challenges to provide care and educate junior doctors (resident physicians) while ensuring learner and patient safety and resource allocation amidst the suspension of standard in-person learning opportunities. We sought to understand both the positive and negative experiences of first-year residents during the first wave of COVID-19, as well as to describe potential ethical issues from their stories. Method: We used narrative inquiry (NI) methodology to explore resident physicians’ experiences. A semi-structured interview guide was utilized and included questions pertaining to ethical principles as well as both positive and negative aspects of the pandemic. Sampling was purposive. Interviews were audio-recorded and transcribed. Three members of the research team coded transcripts in duplicate to determine themes surrounding experiences as well as observations of ethical principles and arguments. To describe resident experiences of both the positive and negative aspects of the pandemic, a composite story with threads was constructed. Discrepancies were resolved through discussion to attain consensus. Results: Eleven residents participated from Internal Medicine (n=2), Family Medicine (n=2), Ophthalmology (n=1), General Surgery (n=1), Pediatrics (n=1), Diagnostic Radiology (n=1), Public Health (n=1), Psychiatry (n=1), Emergency Medicine (n=1). Resident stories had three common themes in which ethical issues were described: 1) Intersecting healthcare and medical education systems, 2) Public health and the public good, 3) Health systems planning/healthcare delivery. Junior’s journal entry became the composite story of the eleven participants. Three key narrative threads of the story were: 1) Engage us, 2) Because we see the need for the duty to treat, 3) And we are all in this together. Discussion: While residents identified lack of autonomy as they straddled roles as both novice employees and learners across intersecting systems, this was not unique to the pandemic. The pandemic, however may have exacerbated the lack of autonomy experienced by resident physicians. The notion of public health and the public good at times eclipsed individual wellbeing for residents and patients alike, leading to consequences in health systems’ planning/healthcare delivery. Despite these challenges, there were positive aspects to the pandemic such as teamwork and collaboration as well as the feeling of altruism to help achieve what was best for the public good. Conclusion: Efforts to understand how resident physicians can be engaged in their own education as well as how they can navigate public health crises with respect to ethical principles could benefit both residency education and healthcare delivery.
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    Sharing longitudinal, non-biological birth cohort data: a cross-sectional analysis of parent consent preferences
    (2018-11-12) Manhas, Kiran P; Dodd, Shawn X; Page, Stacey; Letourneau, Nicole; Adair, Carol E; Cui, Xinjie; Tough, Suzanne C
    Abstract Background Mandates abound to share publicly-funded research data for reuse, while data platforms continue to emerge to facilitate such reuse. Birth cohorts (BC) involve longitudinal designs, significant sample sizes and rich and deep datasets. Data sharing benefits include more analyses, greater research complexity, increased opportunities for collaboration, amplification of public contributions, and reduced respondent burdens. Sharing BC data involves significant challenges including consent, privacy, access policies, communication, and vulnerability of the child. Research on these issues is available for biological data, but these findings may not extend to BC data. We lack consensus on how best to approach these challenges in consent, privacy, communication and autonomy when sharing BC data. We require more stakeholder engagement to understand perspectives and generate consensus. Methods Parents participating in longitudinal birth cohorts completed a web-based survey investigating consent preferences for sharing their, and their child’s, non-biological research data. Results from a previous qualitative inquiry informed survey development, and cognitive interviewing methods (n = 9) were used to improve the question quality and comprehension. Recruitment was via personalized email, with email and phone reminders during the 14-day window for survey completion. Results Three hundred and forty-six of 569 parents completed the survey in September 2014 (60.8%). Participants preferred consent processes for data sharing in future independent research that were less-active (i.e. no consent or opt-out). Parents’ consent preferences are associated with their communication preferences. Twenty percent (20.2%) of parents generally agreed that their child should provide consent to continue participating in research at age 12, while 25.6% felt decision-making on sharing non-biological research data should begin at age 18. Conclusions These finding reflect the parenting population’s preference for less project-specific permission when research data is non-biological and de-identified and when governance practices are highly detailed and rigourous. Parents recognize that children should become involved in consent for secondary data use, but there is variability regarding when and how involvement occurs. These findings emphasize governance processes and participant notification rather than project-specific consent for secondary use of de-identified, non-biological data. Ultimately, parents prefer general consent processes for sharing de-identified, non-biological research data with ultimate involvement of the child.
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    Social Workers' Experience of Moral Distress
    (2016) Jaskela, Shannon; Mitchell, Ian; Page, Stacey; Guichon, Juliet
    According to Jameton (1985), “moral distress arises when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action” (as cited in Pendry, 2007, p.1). The issue of nurses and moral distress has been studied extensively; however, little attention has been paid to social workers’ experience of moral distress. The main objectives of this qualitative descriptive research were to explore whether ten health care social workers experienced moral distress and, if so, what were the causes and effects of such moral distress. The supports they use to deal with such distress were also explored. The participants voiced that they experience moral distress from a variety of sources and that the effects of such distress can result in exhaustion, apathy towards patients, and social workers leaving their positions. The results of this research are discussed and suggestions for further research and practice are presented.
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    The Experiences, Opinions and Use of Complementary and Alternative Medicine (CAM) among Alberta Midwives
    (2017) Oguaju, Chinelo; Page, Stacey; Dewey, Deborah; Wolbring, Gregor
    Background: Midwives are maternity care providers who may recommend or provide CAM to assist with their clients’ pregnancy and childbirth, and early neonatal health. Objectives: To describe use, experiences, opinions and perceived CAM educational needs of midwives in Alberta. Method: A descriptive survey of Alberta Midwives. Result: The response rate was 23.7%. Slightly more than 90% of the participating midwives very often recommend CAM and 45.8% very often provide CAM to their patients. Client preferences and scientific evidence of efficacy were the most common reasons for recommending CAM. More than two-thirds (70.8%) of respondents believed that they lacked adequate CAM education. Participant midwives support the use of CAM and its integration into midwifery. Conclusion: CAM was frequently recommended by the midwives who participated in this study. However, the majority of the participants indicated that they lack adequate CAM knowledge and education. Consequently, providing more CAM education opportunities is needed.
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    Understanding the Knowledge, Perception, and Experiences of Patients about Precision Medicine and Biobanking; A Qualitative Study
    (2022-02) Haque, Mohammad; Page, Stacey; Santana, Maria; Roach, Pamela; Dubyk, Alexander-Sandy; Syme, Rachel
    Chronic Kidney Disease (CKD) patients’ knowledge, perception, and experiences surrounding Precision Medicine (PM) and biobanking were explored in this study. This study used a qualitative methodology. Data was collected by individual virtual interviews utilizing a semi-structured open-ended interview guide. Framework analysis was used on the resulting transcripts. Methodological rigor was achieved through credibility, reliability, and reflexivity. Four themes were identified concerning CKD patients’ knowledge, perception, and experiences of PM: benefits, concern, perceived barriers to implementing PM, and preferences on the informed consent model. Another four themes were identified regarding CKD patients’ knowledge, perception, and experiences of biobanking: benefits, concern about biobank research or donation of samples, factors that influence participation in biobank research, and ownership of donated samples. This unique study investigated the knowledge, perception, and experiences of CKD patients about PM and biobanking. The study results may help support programs and provisions that aim to overcome challenges that hinder a patient’s participation in PM and biobank research and consequently amplify patient engagement and awareness in PM and biobank research studies. In the end, the information gained from this study will add value to future PM and biobank research and clinical initiatives.