Nursing

The Impact of the COVID-19 Pandemic on Black People in Toronto: Informing Public Health Nurses on What They Can Do: A Scoping Review by Fitzroy H. Thompson MScN, explores Black people in low-income neighbourhoods being at increased risk of COVID-19 infection and death due to longstanding health inequity. The research consisted of white and grey literature from Canada between March 2020 and November 2022 using the Social Determinants of Health (SDH) framework. Falk-Rafael's Critical Caring Theory (CCT) guides the critical review of the research collected from the systematic search (Butcher, 2022). The SDH plays a vital role in health outcomes for Black people's access to optimal health services. Community nursing practice can optimize COVID-19 research to advocate for structural interventions tailored to improve SDH access and develop solutions to address needs for policy evolution. The findings act as the foundation for a systematic review and a scholarly synthesis of the evidence on the research question, which would further contribute to the enhancement of nursing care for Black people in low-income neighbourhoods.

Author Keywords: Black people, COVID-19, public health, race, racism, social determinants of health

Lyme disease (LD), caused by Borrelia burgdorferi, presents major diagnostic and treatment challenges due to its diverse symptoms and often ambiguous progression. Despite growing awareness, many patients face misdiagnosis, dismissal, and inadequate care—especially in North America, where brief treatment guidelines may fail to address persistent symptoms. This qualitative study used a phenomenological approach to explore the lived experiences and adaptive strategies of 16 individuals diagnosed with LD for over a year. Semi-structured interviews were analyzed using thematic analysis and Interpretative Phenomenological Analysis (IPA), revealing five key themes: medical journey and testing accuracy, functional and cognitive suffering, mental and emotional impacts, adaptive practices, and advocacy for systemic reform. Participants reported significant disruptions to daily life, reliance on alternative care, and frustration with mainstream medicine. Their narratives underscored institutional shortcomings and highlighted the need for improved education, diagnostic protocols, integrative care access, and patient-centered policies. This study contributes valuable insights into chronic illness care and contested disease recognition.

Author Keywords: Adaptive practices, Lived experiences, Lyme Disease, Mental health, Nursing, Public health

The prevalence of hypertension and mental illness among Black Canadians is a growing public health concern. There is a paucity of Canadian research exploring the lived experiences of Black individuals with both hypertension and anxiety, particularly in relation to how racism shapes access to healthcare. This study aimed to advance awareness and cultural understanding of systemic and institutional racism, with a focus on its impact on access to care. A qualitative design employing descriptive and interpretive phenomenology was used. Ten participants were recruited through purposive sampling. Data were collected via semi-structured interviews with Black individuals residing in the Greater Toronto Area (GTA). Key findings suggest that racial inequities and disparities continue to directly affect the quality of care received, with racism emerging as a persistent barrier. These findings underscore the need for culturally responsive, equitable care approaches to address the structural barriers faced by Black communities in Canada.

Author Keywords: anxiety, Black health disparities, healthcare access, hypertension, institutionalized racism, racial inequities in healthcare

Older adults with dementia experience higher rates of hospitalization than those without dementia, yet nurses in acute care frequently feel unprepared to support patients with responsive behaviours using non-pharmacological approaches. The aim of this study was to explore the experiences of nurses' using activity-based interventions, such as colouring, word games, therapeutic dolls, and mechanical pets, with patients with dementia in a small community hospital. Using a qualitative interpretive descriptive method, face-to-face semi-structured interviews were conducted with ten nurses (five Registered Practical Nurses, two Registered Nurses, and two Nurse Practitioners). Data were analysed using Braun and Clarke's reflexive thematic analysis. Five major themes and multiple sub-themes were identified: (1) enhancing safety, stability, and emotional well-being, (2) facilitating engagement through practical and adaptive strategies, (3) collective responsibility and collaboration, (4) opportunity for deeper understanding and connection, and (5) challenges implementing activity interventions. The findings highlight how activity-based interventions enhance relational, person-centred care while revealing barriers related to resources, time, and knowledge. These results can inform the Canadian Gerontological Nurses' Association's aesthetic/artful standard and reinforce the need for enhanced dementia education for nurses and evaluation of activity-based interventions.

Author Keywords: activity, acute care nursing, dementia care, gerontological nursing, non-pharmacological interventions, responsive behaiours

This study examines the experiences of Tamil Canadian caregivers providing home care for older adults with dementia, highlighting their unique challenges. Grounded in a social constructivist and phenomenological approach, the qualitative research explores the influence of social, cultural, and familial expectations on caregiving roles. Semi-structured interviews with ten Tamil Canadian caregivers revealed difficulties in accessing healthcare, managing complex care needs, and balancing personal well-being with caregiving responsibilities. Language barriers and limited awareness of available health and social services further exacerbated emotional, financial, and physical burdens. Caregivers expressed a strong need for educational resources to enhance their skills and support their roles. Despite these challenges, participants reported emotional rewards, such as strengthened family bonds and a profound sense of duty. The study underscores the importance of tailored interventions, advocating for culturally responsive services, language support, and caregiver education to better address the needs of Tamil Canadian caregivers.

Author Keywords: caregiver burden, cultural barriers, cultural values in caregiving, language barriers, self-care for caregivers., tamil Canadian caregivers

I utilized analytical autoethnography to analyze and interpret my own experience of what caring for a child that died was like for me within the academic and institutional culture that I was educated and trained in (Chang, 2008). Themes of lack of preparedness, relationships, loss and emotion, death denial, and lasting impacts and growth were identified. Pediatric death and dying education and training for nurses should encompass nursing responsibilities, communication strategies, holistic assessments, symptom management, cultural awareness, and grief literacy (Bensoussan, 2024; Chew, Ang, & Storey, 2021; Kent, Anderson, & Ownes, 2012; RNAO, 2012). A system to accommodate, acknowledge, and value emotion. A platform to share, learn, and grow from the experience with death and dying. This autoethnographic account provides insights into the personal and professional impacts of pediatric patient death on nurses and the importance of associated education, training, and support to improve care for patients, families, and self.

Author Keywords: autoethnography, lasting impacts, metabolizing grief, nurse, pediatric patient death, self-transformation

The involvement of families in the care of their infant in the Neonatal Intensive Care Unit (NICU) may be influenced by the unit environment (O'Brien et al., 2013). The purpose of this study is to explore the influence of the open pod NICU through the research question: What is the impact of unit design in the NICU at Kingston General Hospital (KGH) on the lived experiences of families? A qualitative descriptive design was followed using semi-structured interviews conducted with family members of infants in the NICU at KGH. Themes constructed through thematic analysis of transcripts included Needing more space, Creating a comfortable environment, Having a sense of community, Desiring consistency in staffing and Barriers to being present. The narrative of these themes aligns with Donabedian's (2003) theoretical model of structure, process and outcome. The findings from this research indicated that being cared for in an open pod NICU impacted their family experiences, displaying areas for improvement in future NICU designs.

Author Keywords: Family experience, FiCare, Neonatal Intensive Care Unit (NICU), NICU design, NICU environment, Open pod NICU

Inserting a peripheral intravenous catheter (PIVC) can be a stressful moment in a patient's hospital stay, especially in patients with difficult intravenous access (DIVA). This study investigated the applicability of a mid-range theory of trauma-informed care (BITTEN) to PIVC insertion in DIVA patients. A qualitative, semi-structured interview was conducted with 17 DIVA patients. Data was analyzed by item and compared to the BITTEN model. Key findings include: the BITTEN model can help explain the traumatic experiences DIVA patients have with PIVC insertion, DIVA patients have experienced institutional betrayal after medical and other traumas, previous adverse PIVC experiences inform expectations for future experiences, and DIVA patients' trust in clinicians is restorative. In fact, adverse PIVC experiences have little to do with the needle itself.

Author Keywords: access, betrayal, DIVA, intravenous, peripheral, trauma

Nurses have a vital role in counselling their patients towards healthier living. However, nurses tend to have poor metabolic health that may be influenced by lifestyle. Whether this begins during their nursing education is poorly understood. Undergraduate nursing (n=42) and biology (n=15) students had their metabolic health assessed through body measurements, fasting blood glucose and lipids. Lifestyle factors of physical activity, nutrition, stress, and sleep were assessed using questionnaires, accelerometry, diet logs, and heart rate variability. At an individual level, 31.0% of nursing students are at-risk of poor metabolic health. Results suggest that nursing students are sedentary, obtaining poor sleep quality, consuming elevated amounts of saturated fat, and perceiving themselves to be under mild stress. The implementation of lifestyle interventions should be considered for this cohort. However, few differences were found between nursing and biology groups, indicating that the results are potentially generalizable to a larger group of undergraduate students.

Author Keywords: metabolic health, nursing students, nutrition, physical activity, psychological stress, sleep quality

Vaccine hesitancy continues to influence public health practice in Ontario, particularly within a system that requires parents to complete non-medical exemptions under the Immunization of School Pupils Act, 1990. The purpose of this study was to explore how vaccine-hesitant parents understand their decisions and navigate institutional processes during the exemption pathway. Using Thorne's (2016) Interpretive Description, seven parents from Ontario participated in semi-structured interviews focused on experiences of trust, communication, and interactions with public health. Themes developed were:mutual othering, the role of epistemic conflict, vaccine refusal and exemption as symbolic resistance and restructuring trust through relationships. These findings show that vaccine decision-making is influenced not only by beliefs about safety or access, but also by the relational and moral context in which information is delivered. The study offers insights for public health nursing practice by highlighting the importance of relational approaches, ethical communication, and trust-building within mandatory immunization systems.

Author Keywords: immunization policy, institutional trust, interpretive description, parental decision-making, public health nursing, Vaccine hesitancy