Attachment, psychological functioning, and resilience within the street involved youth populations: describing youth who access community agency support

Youth homelessness is defined within the literature as youth who have left their homes and are living independent of parental figures and/or caregivers, have no stable residence or source of income, and lack access to the supports needed to make the challenging transition into adulthood (Canadian Observatory on Homelessness, 2015). Previous research studying homeless (or street-involved) youth has primarily focused on risk factors hindering the development of this population, and has largely ignored resilience, coping, and help-seeking behaviours. The current study examined the attachment styles (both categorically and dimensionally), psychological functioning, resilience, and help-seeking behaviours in street-involved youth of St. John’s, Newfoundland. Face-to face interviews were completed over a four-month period with 63 youth (42 males, 21 females) aged 15-29 (Mage = 20.00), recruited from a local community organization providing outreach services to street-involved youth. Results revealed the disproportionate struggles of the street-involved youth population, and highlighted higher levels of attachment insecurity, psychological distress and lower resilience compared to normative peers. Findings also showed a significant difference in psychological functioning, overall resilience, and emotional reactivity based on individual attachment style. In an exploratory model of help-seeking, a positive relationship was found between overall resilience (defined as a sense of mastery and sense of relatedness) and frequency of community service access. However, contrary to predictions, no relationships were found between frequency of community service access and attachment, psychological functioning, or emotional reactivity. Implications of the present findings in development of interventions for street-involved youth are discussed, in addition to strengths and limitations of the present research, and suggested areas of future inquiry.

Development of an education resource for families and clients navigating through end-of-life care with at-home palliation

Background: Community health nurses (CHNs) play a pivotal role in providing end-of-life care to clients diagnosed with a life-threatening illness. Providing quality end-of-life care is an ethical obligation. Eastern Health’s palliative end-of-life care program (PEOLC) offers nursing care, equipment, services, and support. However, the caregiver’s need for practical information about end-of-life issues is not addressed. Purpose: To develop an educational resource to assist clients and families during end-of-life and to provide a framework for new CHNs in home palliation. Methods: An informal Needs Assessment, a literature review, an environmental scan, and consultations with four CHNs involved with home palliation. Results: An educational resource was developed to address the practical end-of-life issues identified in the literature review and consultations. Conclusion: An improved delivery of care for at-home palliation in the community for clients and families, and a framework for new CHNs.

Caring for the autistic child: a resource manual for health care providers

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects approximately 1 in 68 children (CDC, 2014). Comorbid medical conditions and psychiatric disorders increase the likelihood that these children will require acute care services more often than their neurotypical peers (McDermott, Zhou, & Mann, 2008; Simonoff et al., 2008). The evidence suggests that most health care providers are unprepared for the complexity of the interactions with these children during an acute care episode (McGongile, Migyanka, et al., 2014; McGongile, Venkat, et al., 2014; Muskat et al., 2015). Currently, there are no formalized training programs for acute health care workers in Regina Qu’Appelle Health Region (RQHR). Purpose: The purpose of this practicum project was to use the best available evidence on the care needs of children with Autism Spectrum Disorder (ASD) and effective interaction strategies to guide development of a resource manual for acute care health workers, especially registered nurses (RNs), working in the RQHR. Methods: Initial steps involved planning for and conducting a needs assessment. The resulting database emerged from a critical review of relevant literature, an environmental scan of resources within RQHR, and informal consultations with parents and caregivers of children with ASD, acute care nurses and nurse managers and experts in the field of ASD. Following analysis and collation of all data into major themes, a draft blueprint guided development of a resource manual for health care providers interacting with and providing care to children with ASD. Results: The needs assessment data informed development of an educational resource manual appropriate for all health care providers who encounter children with ASD and their parents and/or caregivers within acute care environments. The Caring for the Autistic Child: A Guide for Health Care Providers in Acute Care provides insightful information on the disorder and associated comorbid conditions, as well as effective approaches to care delivery with this priority population. Implementation and evaluation plans will guide distribution of the resource manual within the RQHR. Conclusion: The sequential and interdependent steps taken in this practicum project led to the development of a resource manual comprised of simple, easy to implement strategies capable of assisting nurses and all healthcare providers in providing care tailored to the autistic child’s unique needs and challenges.

The first time delivery of the first link learning series using Skype and YouTube

Introduction: This case study documented the experiences of informal and service providers who participated in the first time delivery of the First Link Learning Series from May–August 2013 in Newfoundland and Labrador. The aim of this study was to understand how informal caregivers of people with dementia experience this Internet mediated health resource, and how Skype and YouTube can be used as tools for the Alzheimer Society of Newfoundland and Labrador to effectively deliver the First Link Learning Series. Methods: Sources of data included key informant interviews (n=3), pre- study and post-study interviews with informal dementia caregivers (n=2), institutional documentation, field notes, and YouTube analytics. Framework Analysis was used to make meaning of the qualitative data, and descriptive statistics were used to report on quantitative outcomes. Findings: Between 3% and 17% of registered First Link clients attended the learning series sessions, however only two caregivers participated using Skype or YouTube. Framework Analysis revealed three shared themes: access, connection and privacy. Discussion: The themes helped to begin building theory about barriers and facilitators to Internet mediated health resources for informal dementia caregivers. Experiences of service providers using the Internet to support clients served to begin building a case for the appropriateness of these media. A modified version of Dansky et al.’s (2006) theoretical framework for evaluating E-Health research that situates the person/user in the model, helped guide discussion and propose future directions for the study of Internet based health resources for informal dementia caregivers.