Wellspring: an intrinsic case study of community-based education for adults living with cancer /

This paper presents education research as vital to addressing the issues faced by adults living with cancer. This qualitative study looked at philosophies of practice for cancer patient education. It was about understanding how values and beliefs shape the way program planners and managers operationalize their knowledge of adult education and how this has significant impact on meeting the needs of those touched by cancer. Improved technology has extended life expectancy, so that Canadians living with cancer, or even dying with cancer now spend less time in direct medical care. The notion of cancer as simply a medical concern is outdated. This study found that informational and support needs of adults living with cancer are often unmet, ignored or unknown. This research investigated a community-based education initiative that is inviting, accessible, and promotes a sense of hope. More specifically, this case study uncovered factors contributing to the success of Wellspring, a grass-roots cancer patient support centre which has been recognized nationally for its ability to effectively meet the diverse non-medical supportive care needs of as many cancer patients and caregivers as possible. Therefore, Wellspring was selected as a case study. Educating people to take charge of their own lives and supporting them in making informed decisions about their lifestyle choices made Wellspring part of a social action movement that focused on improving social attitudes toward people living with cancer. Results of this descriptive inquiry and philosophical inquiry evolved into data that was used to devise an organic model of community-based education that encompasses Adler's (1993) four dimensions of philosophy within a socio-cultural context.

Examining the influence of family support on diabetes education behavioural outcomes

The purpose of this study was to examine the influence of family support on diabetes education behavioural outcomes, specifically in relation to diet, exercise, and blood glucose monitoring in adult individuals with Type 2 diabetes. Fifty-three individuals attending diabetes education for the first time were followed approximately 1 month. The findings for the influence of family support were mixed. Family attending diabetes class with participants had a positive influence with respect to diet. This is consistent with Carl Rogers (1969) who espouses setting a positive climate for learning and that learning new attitudes or information comes when external barriers are at a minimum. However family attending class with participants had no influence with respect to exercise or blood glucose monitoring. The family support action of encouraging with respect to diet overall did not influence healthy eating behaviours except for decreased skipped meals and scheduled snacks. In fact, in the areas of family willing to make healthy choices along with participant, the less the family was involved in encouraging, the better the participant did. Exercise on the other hand was influenced positively by family encouragement. This is consistent with Bandura's theory that enhancement of self-confidence and self-efficacy can lead to desired behaviour changes. Family encouragement however did not appear to influence blood glucose monitoring behaviours. This study has implications for practice in that diabetes education programs can encourage family to attend classes or get involved in encouraging the person with diabetes, so that it may help to increase healthy eating behaviours and exercise. As time is necessary to implement changes in behaviour, future research can look at the influence of family support over a 6-month, I-year, or greater period.

Factors affecting treatment decision making for women with breast cancer

This study examined the factors affecting treatment decision making for young women with early stage breast cancer. Thirty women, aged 35 to 52 years, were presented information about two equally effective chemotherapy treatments following surgery for breast cancer using an educational instrument called a "decision board." Although equally effective, the treatments differ with regards to side effects and treatment schedule. The purpose of this research was to investigate what factors affect the decision-making process. Following administration of the decision board, women were given a take-home version to review and asked to return one to two weeks later with a decision, at which time they completed a questionnaire. theoretical framework for this study was constructed from the literature on self-directed learning and critical thinking. The Overall, the factors rated most important to the treatment decision were related to quality of life, side effects, and length of treatment. Five factors were found to be rated significantly different by the women who chose one treatment versus the other in terms of importance to their decision. These were side effects in general, vomiting, hair loss, family role, and the number of trips to the cancer centre required for treatment.Implications and recommendations for patient education, research, and practice evolved from the findings of this study.

An examination of outdoor experience in the development of character in young adults with Type 1 Diabetes

Connected in Motion is a not for profit organization serving young adults with Type 1 diabetes. The organization hosted outdoor and experiential Type 1 diabetes education programs in January of2009 and 2010. The weekends provided non-clinical alternative Type 1 diabetes education to the underserved population of young adults within Canada. Six women living with Type I diabetes and between the ages of 22 and 30 participated in the Winter Slipstream weekends participated in this phenomenological research study. Through semi-structured interviews and artifact-elicitation interviews, ,{ the lived experiences of the participants were examined. Data analysis indicated that the sense of community created through outdoor programming and experiential education for young adults with Type I diabetes stimulated the development of self-efficacy and participant-perceived improvement in Type 1 diabetes self-management. There was no indication that outdoor and experiential Type I diabetes education had any impact on the development of autonomy among participants. Recommendations are made to encourage the successful implementation of further alternative (non-clinical) Type 1 diabetes education programs for young adults living with Type 1 diabetes.

Using Poetry, Story, and Reflection to Understand Professional Self After Personal Loss

This research investigated professional identity transformation after personal loss. Through autoethnographic methods, I explore how my personal experience of my sister’s breast cancer and death affected my identity as a diabetes educator in the health culture. I discover a transformation of a professional who focuses on evidence-based medicine to a professional who values connection, therapeutic alliance, and mindfulness with patients and self in the diabetes education encounter. Using a holistic perspective on transformational learning, I integrate the poem “Wild Geese” to a collection of written narratives to connect my personal loss experience to my professional life. By unpacking the generated stories and using poetry, I conduct a process of critical and self-reflection to discover how my identity as a health professional has transformed and what makes meaning in my role as a diabetes educator in the health culture. I consider concepts of a conscious self, social relations and language and discover themes of knowledge exchange, food, and empathy as forms of language expression. These language expressions are not present in my professional life as I focus on rational, logical facts of evidence-based medicine and standardized education methods. Through this reflexive process, I hope to understand how my professional practice has changed, where I place an importance on connection, therapeutic alliance, and mindfulness. I move away from always “doing” in my professional life to focus on my state of “being” in my professional world. Rather than knowledge acquisition as the only factor in professional development, this study contributes to an understanding of additional qualities health professionals may consider that focus on the patient education encounter.

Effect of combined care nursing on patient satisfaction, staff satisfaction, and quality of care /

This research evaluates the effect of combined care nursing on three outcomes: i) patient satisfaction; ii) staff satisfaction; and iii) quality of care. Oakville-Trafalgar Memorial Hospital was in the early planning stages of changing to combined care nursing from the traditional method of providing separate postpartum and nursery care to mothers and babies. The opportunity existed to evaluate formally the change to combined care. There were three hypotheses to be investigated. Data were collected from four sources: patient surveys, staff surveys, informal interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. The surveys were administered on three different occasions to patients and staff. Other sources of data included informal interviews with patients and staff who responded to the surveys, and chart audits.The study findings revealed that the majority of respondents had increased levels of satisfaction and perceptions of increased quality of care following implementation of combined care. These findings, related to combined care and the role of change in its implementation and evaluation, indicate that there are no right or easy answers about how to make new ideas become reality in a smooth, pleasant way.