Browsing by Author "Verhoef, Marja J."

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    A combined-methods study of the training and practice of Alberta's therapeutic massage bodywork providers
    (2012-09-05) Porcino, Antony; Verhoef, Marja J.
    Background Therapeutic massage bodywork (TMB) therapies are commonly used by the public, nevertheless, research validating TMB is nascent. Practitioner variability may be affecting research outcomes. This study therefore describes and explores the relationship between therapist variables (e.g., training, practice focus) and clinical TMB experience, and the consequent implications for TMB research. Methods A combined methods design, consisting of a quantitative, population-based survey and qualitative interviews with practitioners trained in multiple therapies, was used to explore the training and practice of TMB practitioners in Alberta, Canada. Results Of the 5242 distributed surveys, 791 were returned (15.1%). The sample demographics did not significantly differ from other massage therapist study populations. Practitioners were trained in 77 distinct TMB therapies. Most practitioners (94.4%) were trained in two or more therapies, with a median of 8 and range of 40 therapies. Training programs varied widely in number and type of TMB components, training length, or both. Nineteen practitioners trained in multiple TMB therapies were interviewed. Participants reported greatly varying training backgrounds, resulting in practitioners learning and practicing unique combinations of therapy techniques. Moreover, all practitioners described addressing patients’ needs by providing individualized patient treatment based on a responsive feedback process throughout practice. Additionally, practitioners distrust TMB research results because of perceived and actual treatment provision differences between TMB clinical practice and TMB treatments used in research. Conclusions The training received, the number of therapies trained in, and the practice descriptors of TMB practitioners are all highly variable. Clinical experience and continuing education may further alter or enhance treatment techniques. Therefore, treatment provision and individualization are likely practitioner-specific. Practitioners surmise that clinical trials do not accommodate practitioner variability or treatment individualization, resulting in limited clinical application of TMB research. The high variability in training and experience between practitioners necessitates improved research reporting of practitioner qualifications and expertise, and the consequent impact on the results. TMB research designs need to accommodate the inherent individualization of clinical practice and capture relevant contextual outcomes. Knowledge translation of research results must address TMB practitioners’ perceived differences between TMB research treatments and TMB clinical practice.
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    Assessment of bony damage using high resolution peripheral quantitative computed tomography (HR-pQCT) in rheumatoid arthritis
    (2011) Barnabe, Cheryl Carmelle Marie; Barr, Susan G.; Martin, Liam; Verhoef, Marja J.
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    Complementary and alternative medicine decision making by women with fibromyalgia
    (2006) Vroegindewey, Annette; Verhoef, Marja J.
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    Developing a Framework for Understanding Organizational Culture in Healthcare Organizations from a Complex Adaptive Systems Perspective
    (2012-10-03) Yelland, Gregory; Scott, Catherine; Verhoef, Marja J.
    Most conceptual models of organizations, including the dominant frameworks for understanding and assessing organizational culture, rely on a mechanistic view of organizational dynamics. Although popular, the mechanistic view is inherently simplistic and fails to address the complexity of contemporary organizations (Boan & Funderburk, 2003; Clancy, 2007; Clancy, 2007; McDaniel & Driebe, 2001; Plsek & Greenhalgh, 2001; Rowe & Hogarth, 2005; Seel, 2000, Seel, 2005). This research project attempted to provide a more comprehensive conceptual tool through developing and assessing a framework based on the key properties of the complex adaptive systems perspective. The new Complex Adaptive Systems – Organizational Culture (CAS-OC) Framework developed in this research was then assessed with relation to use in health care organizations. This framework was developed through a mixed methods research design consisting of three phases. Phase one involved a systematic scoping review of the organizational culture and complex adaptive systems literature. The review of the organizational culture literature resulted in identification and screening of 12,154 peer-reviewed articles and 1,660 grey literature documents. A total of 215 documents met the inclusion criteria and were reviewed resulting in identification of 14 definitions, 26 frameworks and 123 components of organizational culture. The review of the complex adaptive systems literature resulted in confirmation of the five key properties of complex adaptive systems discussed in the literature. Phase two involved a Delphi study conducted with international organizational culture experts. These experts identified 68 components of organizational culture. Based on their conceptual similarity, these components were combined into 17 factors of organizational culture. The results from phases one and two were added to the newly confirmed list of key properties of complex adaptive systems to inform development of the new CAS-OC Framework. Phase three was the assessment phase. The new CAS-OC Framework was presented to professionals in Alberta healthcare organizations for review and assessment as a potential tool. Their assessment confirmed the categories and components already incorporated in the framework and identified 10 additional components they wanted to see included in the framework. These additional components were examined and incorporated into the new framework if they were not already included. Overall, the assessment participants concluded that the framework was feasible, appropriate, meaningful and effective for use in healthcare organizations in Alberta, specifically Primary Care Networks in Alberta. This research contributed to the body of knowledge in four areas. First, this research examined organizational culture using a phased, mixed method approach. Second, this research confirmed the key properties of complex adaptive systems theory discussed in the complexity literature. Third, this research introduced a complex adaptive systems–based definition and framework for understanding organizational culture in Alberta health care organizations to the current body of knowledge. Finally, this research assessed the Feasibility, Appropriateness, Meaningfulness, and Effectiveness of the CAS-OC Framework from a usability perspective. The research concluded with recommendations for future research.
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    Evaluating complex health interventions: a critical analysis of the 'outcomes' concept
    (BioMed Central, 2009-06-18) Paterson, Charlotte; Baarts, Charlotte; Launsø, Laila; Verhoef, Marja J.
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    Experiences of vulnerable women in a prenatal education class in Calgary: An ethnographic approach
    (2014-09-30) Yumakulov, Sophya; Verhoef, Marja J.
    Vulnerable populations are under-represented in prenatal education and experience barriers to access despite many programs being free of charge. Understanding how vulnerable women perceive and experience prenatal education can point to what factors might aid in recruiting and retaining them in education programs. I conducted an ethnographic study of prenatal classes at the Calgary Pregnancy Care Centre. Through observations, field notes, and in-depth interviews with participants, four main themes emerged: Perceptions of the class - classes were seen as a source of social support (esp. for lone mothers) as well as formal knowledge about pregnancy and birth; The “nature” of the client – instructors’ assumptions about the “nature” of the clients dictated how the classes were run; Formal knowledge vs. experiential knowledge, and Lone mothers and the role of partners. Prenatal education programs should consider the diverse perspectives which surround and shape vulnerable women’s experiences of prenatal education.
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    Exploring the Professional Role of Massage Therapists in Patient Care in Canadian Urban Hospitals – A Mixed Methods Study
    (2014-01-29) Kania-Richmond, Anna; Verhoef, Marja J.; Suter, Esther; Reece, Barbara
    Background: Massage therapy (MT) is becoming established as a recognized health care profession. MT services are being incorporated into various types of health care settings, including hospitals. However, little is known about the delivery of MT services and the role of massage therapists in patient care in hospitals in the Canadian context. Purpose: The purpose of this study was to conduct a comprehensive examination of massage therapy incorporation into Canadian urban hospitals. Methods: A mixed methods study design was used. The quantitative phase (survey) and qualitative phase (semi-structured interviews) were conducted sequentially, with an emphasis on the qualitative phase. The survey was conducted in settings where MT services were organized by hospitals and provided by licensed massage therapists to patients. Semi-structured interviews were conducted with a purposively diverse sample of participants. The quantitative and qualitative approaches were mixed during data collection and analysis. Results: Sixteen urban hospitals across Canada (5%) provided MT to patients by licensed therapists. The majority of hospitals were located in Ontario and ranged from specialized small community hospitals to large multi-site hospitals. Three MT delivery approaches emerged: stand-alone, closed-incorporated, and open-incorporated. In addition to clinical functions as health care providers and team members, components of the massage therapists’ professional role included: program support, educator, promotor, and researcher. Role related experiences suggested the presence of ambiguity regarding the massage therapists’ role, overlap with other health care professionals (HCPs), role overload related to limited availability of time and massage staff, and role conflict. Patterns suggesting variations in the role components and types of role experiences across study sites and in relation to team member status were apparent. However, the small sample size precluded further analysis of these potential differences. Conclusions: While hospital-based MT in Canada is not a new phenomenon, MT is not yet an established health care profession in hospitals. However, there is significant potential for the inclusion of the MT role in Canadian hospitals that should be research-informed for effective implementation.
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    Feeding practices of Vietnamese infants: a comparative study
    (1996) Douglas, Kathleen L.; Verhoef, Marja J.
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    Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study
    (BioMed Central, 2010-01-14) Verhoef, Marja J.; Mulkins, Andrea; Kania, Ania; Findlay-Reece, Barbara; Mior, Silvano
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    Qualitative evaluation of a rural Alberta community development project
    (1994) Sommer, Sheilah D.; Verhoef, Marja J.
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    Quality of life and satisfaction with care in a pediatric neurology clinic
    (2004) Mah, Jean Kit-Wah; Tough, Suzanne; Verhoef, Marja J.
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