In recent years nursing literature has featured a proliferation of discourse pertaining to many aspects of spirituality in nursing. However, there has been a dearth of research related to nurses' personal spirituality and whether or not it helps to shape their nursing practice. This qualitative study explored how spirituality shapes the practice of community health nurses who work in First Nations communities in British Columbia (B.C.). The twelve participants, purposefully sampled, all had at least 2 years experience working in community health in First Nations communities. Using an interpretive descriptive research design, participants were interviewed to explore their lived experiences of spirituality relative to their nursing practice. The analysis of the interview data identified that nurses' spirituality is essential to their practice in terms of "providing care spiritually" versus "providing spiritual care" interventions to their patients as typically depicted in the nursing literature. Moreover, their spirituality is discussed as a pervasive nursing ethic and motivation for patient care that manifests as respect, connectedness, love, acceptance, caring, hope, endurance and compassion towards patients. Furthermore, the findings of this study suggest the integration of community health nurses' spirituality into their nursing practice may contribute to the wider aim of health and healing within First Nations communities. Four major themes are presented as research findings: (a) spirituality influences nurses' ability to remain self aware, open-minded and accepting in relation to others; (b) spirituality as a reflexive approach to grounding one's own nursing practice; (c) spiritual awareness fosters appreciation of the need for community healing, and finally (d) self-reflection and providing care spiritually as a route to reciprocal interaction. Also, it was identified that nurses' spirituality nurtures their reflexivity and helps them to: (a) foster culturally safe relationships with patients, (b) realize how colonial issues influence health status in First Nations patients, (c) recognize that cumulative work stress and burn out can be reduced and prevented through relational spiritual practices, and (d) work through their own values, beliefs and prejudices in order to practice nursing based on a model of reciprocal interaction, and culturally safe approaches.

In recent years nursing literature has featured a proliferation of discourse pertaining to many aspects of spirituality in nursing. However, there has been a dearth of research related to nurses' personal spirituality and whether or not it helps to shape their nursing practice. This qualitative study explored how spirituality shapes the practice of community health nurses who work in First Nations communities in British Columbia (B.C.). The twelve participants, purposefully sampled, all had at least 2 years experience working in community health in First Nations communities. Using an interpretive descriptive research design, participants were interviewed to explore their lived experiences of spirituality relative to their nursing practice. The analysis of the interview data identified that nurses' spirituality is essential to their practice in terms of "providing care spiritually" versus "providing spiritual care" interventions to their patients as typically depicted in the nursing literature. Moreover, their spirituality is discussed as a pervasive nursing ethic and motivation for patient care that manifests as respect, connectedness, love, acceptance, caring, hope, endurance and compassion towards patients. Furthermore, the findings of this study suggest the integration of community health nurses' spirituality into their nursing practice may contribute to the wider aim of health and healing within First Nations communities. Four major themes are presented as research findings: (a) spirituality influences nurses' ability to remain self aware, open-minded and accepting in relation to others; (b) spirituality as a reflexive approach to grounding one's own nursing practice; (c) spiritual awareness fosters appreciation of the need for community healing, and finally (d) self-reflection and providing care spiritually as a route to reciprocal interaction. Also, it was identified that nurses' spirituality nurtures their reflexivity and helps them to: (a) foster culturally safe relationships with patients, (b) realize how colonial issues influence health status in First Nations patients, (c) recognize that cumulative work stress and burn out can be reduced and prevented through relational spiritual practices, and (d) work through their own values, beliefs and prejudices in order to practice nursing based on a model of reciprocal interaction, and culturally safe approaches.

In recent years nursing literature has featured a proliferation of discourse pertaining to many aspects of spirituality in nursing. However, there has been a dearth of research related to nurses' personal spirituality and whether or not it helps to shape their nursing practice. This qualitative study explored how spirituality shapes the practice of community health nurses who work in First Nations communities in British Columbia (B.C.). The twelve participants, purposefully sampled, all had at least 2 years experience working in community health in First Nations communities. Using an interpretive descriptive research design, participants were interviewed to explore their lived experiences of spirituality relative to their nursing practice. The analysis of the interview data identified that nurses' spirituality is essential to their practice in terms of "providing care spiritually" versus "providing spiritual care" interventions to their patients as typically depicted in the nursing literature. Moreover, their spirituality is discussed as a pervasive nursing ethic and motivation for patient care that manifests as respect, connectedness, love, acceptance, caring, hope, endurance and compassion towards patients. Furthermore, the findings of this study suggest the integration of community health nurses' spirituality into their nursing practice may contribute to the wider aim of health and healing within First Nations communities. Four major themes are presented as research findings: (a) spirituality influences nurses' ability to remain self aware, open-minded and accepting in relation to others; (b) spirituality as a reflexive approach to grounding one's own nursing practice; (c) spiritual awareness fosters appreciation of the need for community healing, and finally (d) self-reflection and providing care spiritually as a route to reciprocal interaction. Also, it was identified that nurses' spirituality nurtures their reflexivity and helps them to: (a) foster culturally safe relationships with patients, (b) realize how colonial issues influence health status in First Nations patients, (c) recognize that cumulative work stress and burn out can be reduced and prevented through relational spiritual practices, and (d) work through their own values, beliefs and prejudices in order to practice nursing based on a model of reciprocal interaction, and culturally safe approaches. / Applied Science, Faculty of / Nursing, School of / Graduate

Thesis advisor: Lisa A. Goodman / As poverty rates in the United States increase, women continue to be disproportionately represented among individuals in poverty. As a result of their poverty, low-income women experience a range of acute stressors and chronic life conditions, within a sociopolitical climate that is highly stigmatizing. Not surprisingly, low-income women experience mental health issues at substantially higher rates than their higher-income counterparts. Despite the clear need for mental health services for this population, rates of access to treatment are low and attrition rates are high. The minimal research examining treatment outcomes for low-income women reveals mixed findings. Further, there is little research on low-income women's qualitative experiences of therapy; the role of their poverty and what they perceive to be meaningful and effective. The present study attempted to fill the gap in our understanding of low-income women's psychotherapy needs and experiences, in an effort to offer new insights about directions for research, training, and practice that can improve mental health services for this high-risk population. This study employed a qualitative descriptive methodology to explore low-income women's (n=10) experiences in traditional outpatient psychotherapy, with a particular focus on how poverty shaped their experiences and what they perceived to be most effective and meaningful. Six clusters emerged from data analysis: Awareness, Instrumental support and flexibility, Building strengths, Respect and dignity, Shared power, and Authenticity. These clusters, in turn, coalesced into three overarching themes: Awareness, Practices, and Relational Quality. Awareness pertains to participants' sense that their therapist understood the nature of poverty and was sensitive to the role of poverty-related stressors in their clients' lives. Practices reflects therapists' willingness to respond directly and actively to participants' poverty-related needs, as these are inextricably intertwined with their mental health. Relational quality refers to the participants' view of how therapists approached relational dynamics; in particular, how they negotiated issues such as power and transparency. Findings are discussed in the context of feminist theory and current research. Limitations are also presented along with recommendations for future research, training, and practice. / Thesis (PhD) — Boston College, 2014. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

No description available.

Thesis advisor: Lisa A. Goodman / Those in poverty face myriad stressors, traumatic events, and ongoing hardships; and not surprisingly, struggle with a range of mental health issues. Yet, they are less likely to access mental health services than their middle-income counterparts, and when they do, they are more likely to drop out of treatment prematurely. Although researchers have found that when interventions are tailored to address poverty-related stressors outcomes are dramatically improved, the perspectives of those providing such treatment is rarely described. This qualitative descriptive study of twelve experienced psychologists working with clients in poverty aimed to fill this gap. The study explored the extent to which psychologists develop unique practices for working with low-income clients, as well as the personal and contextual factors that support or hinder these efforts. Findings can be distilled into three categories: Practices unique to working with low-income clients include strategies for addressing power dynamics, managing boundaries, and addressing external stressors as part of the therapeutic process. Therapist attributes key to working with low-income clients include possessing a values-based commitment to working with marginalized groups; possessing experience with, knowledge of, and empathy for the realities of living in poverty; possessing a high degree of self-awareness related to poverty; and possessing a willingness to be deeply affected by the work and cope with negative feelings. Contextual obstacles to working with low-income clients include agency-level and social service system-level challenges. Perhaps the most striking finding was participants' understanding of how conceptualizations of appropriate boundaries need to change in the context of work with this population. Many participants described, for example, giving food to their clients when they were hungry or giving them small amounts of money to help them take care of their most basic needs. The discussion section explores these findings in the context of ecological and feminist theoretical models and current research and describes the implications of the results for research, training, and practice. / Thesis (PhD) — Boston College, 2014. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration–funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an academic health department (AHD) involving the East Tennessee State University College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessment and community-centered practice. Similarly, the COPH recognized the need to expand evidence-based practice implementation and evaluation opportunities for public health students. Personnel from the SCRHD, LIFEPATH, and the COPH developed a formal AHD agreement during the summer of 2012 and launched the program the subsequent fall semester. One aspect of the COPH/SCRHD/LIFEPATH model that addresses financial barriers experienced by other AHDs is the competitive awarding of the coordinator position to a doctor of public health student from the COPH, demonstrating investment in the model by the college. The doctor of public health student gains leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. The SCRHD benefits from the formal academic background of graduate-level interns dedicated to working in the community. This AHD framework offers an opportunity for doctoral-level students to develop practical leadership skills in a health department while enhancing the capacity of the SCRHD and the COPH to serve their community and stakeholders.

Policy-makers, research funders, and practitioners acknowledge the need for theories about the uptake of scientific evidence into policy and programs to reduce population-wide risk factors for the major avoidable chronic non-communicable diseases. Models of evidence-informed practice in public health settings have not been developed through systematic scientific inquiry. This study explores and develops a realistic account of evidence-informed tobacco control practice in Ontario public health agencies. In-depth, intensive, semi-structured qualitative interviews were conducted with twelve local public health agency senior executives and other key tobacco control staff in three diverse public health agencies in Ontario, Canada. Interviews explored aspects of tobacco control related decision-making and practice, as well as supports from regional, provincial, and national levels that might enhance tobacco control practice. Interview data were supplemented by field notes and other documentation provided by interviewees, as well as unobtrusive sources. A grounded theory approach to the analysis of textual data identified six major and many subcategories and dimensions implicated in evidence-informed tobacco control practice in local public health agencies. The major category structure includes: information and evidence, interpretation and decision-making, organizational aspects, organizational environment, practice integration, and time. An overall model and five sub-models were developed describing the relations among core category and sub-category factors. Propositions were developed a priori based on an extensive review of the literature. Potentially relevant social theories and concepts were also identified based on a selective review of the literature, including critical realist and other perspectives pertaining to agency-structure issues. Theories and propositions were reviewed, which resulted in a minor modification to the subcategory structure of one branch. Public health agency tobacco control case descriptions were developed based on a final category structure, including six branches, 27 sub-branches, and 98 twigs, and verified (subject to some adjustments) through a member check. Working knowledge is seen to be complex and socially constructed, incorporating aspects of social cognitive and planned behavior theories and Aristotelian intellectual virtues. Realist social theory offers insights into potential change processes. Contributions of the study of theory, practice and methods are discussed, as are strengths and limitations, and areas of needed future research.

Policy-makers, research funders, and practitioners acknowledge the need for theories about the uptake of scientific evidence into policy and programs to reduce population-wide risk factors for the major avoidable chronic non-communicable diseases. Models of evidence-informed practice in public health settings have not been developed through systematic scientific inquiry. This study explores and develops a realistic account of evidence-informed tobacco control practice in Ontario public health agencies. In-depth, intensive, semi-structured qualitative interviews were conducted with twelve local public health agency senior executives and other key tobacco control staff in three diverse public health agencies in Ontario, Canada. Interviews explored aspects of tobacco control related decision-making and practice, as well as supports from regional, provincial, and national levels that might enhance tobacco control practice. Interview data were supplemented by field notes and other documentation provided by interviewees, as well as unobtrusive sources. A grounded theory approach to the analysis of textual data identified six major and many subcategories and dimensions implicated in evidence-informed tobacco control practice in local public health agencies. The major category structure includes: information and evidence, interpretation and decision-making, organizational aspects, organizational environment, practice integration, and time. An overall model and five sub-models were developed describing the relations among core category and sub-category factors. Propositions were developed a priori based on an extensive review of the literature. Potentially relevant social theories and concepts were also identified based on a selective review of the literature, including critical realist and other perspectives pertaining to agency-structure issues. Theories and propositions were reviewed, which resulted in a minor modification to the subcategory structure of one branch. Public health agency tobacco control case descriptions were developed based on a final category structure, including six branches, 27 sub-branches, and 98 twigs, and verified (subject to some adjustments) through a member check. Working knowledge is seen to be complex and socially constructed, incorporating aspects of social cognitive and planned behavior theories and Aristotelian intellectual virtues. Realist social theory offers insights into potential change processes. Contributions of the study of theory, practice and methods are discussed, as are strengths and limitations, and areas of needed future research.

No description available.