Open Theses & Dissertations

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Aging in place: older adults' perspective of home support services in New Brunswick
(University of New Brunswick, 2019) Chinho, Norma; Read, Emily
Countries facing aging population challenges have to address them in patient-oriented, and evidence-based ways. Seniors desire to age in place. This concept in which one lives in his or her own home for as long as possible carries two-fold benefits. Seniors could live out their days in their homes and the government could potentially reduce seniors' hospitalizations and emergency visits. This would significantly decrease public health spending and improve the quality of life for the elderly. Previous senior home support services investigations in New Brunswick have used province-wide and Francophone perspectives, however, this study utilized a uniquely Anglophone point of view to add to the existing body of knowledge. An interpretive description methodology studied the perspectives of seniors receiving home support services which are publicly funded in New Brunswick. The knowledge gained from this investigation has the potential to further inform policy on serving seniors more effectively and efficiently with input from their own voices. Eight participants aged 65 and older and one caregiver were interviewed for this study. Findings show that seniors desire to age in their own homes and home support services enable this thus assist seniors to carry out successful daily life. However, seniors are experiencing significant gaps in home supports, with the most glaring ones occurring in rural New Brunswick. These gaps include home support worker staffing challenges and professional conduct issues which inevitably lead to unmet home support service needs. More still needs to be done to effectively address these gaps for seniors in the province of New Brunswick.
An exploratory study of the lived experience of infertility among young men after cancer treatment
(University of New Brunswick, 2016) Pereira, Lyzandra Leena; Wilkins, Krista
Although over 75% of adolescent and young adult (AYA) men want to be a father after cancer treatment, they do not know how cancer treatment can affect their fertility. There is a gap in knowledge on how these young men cope with infertility in their everyday lives. Accordingly, a qualitative study guided by the philosophy of hermeneutic phenomenology was conducted to elicit detailed descriptions of the lived experience of infertility among young men after cancer treatment. Data were collected through semi-structured interviews with young men, reflexive journal, field notes and documents. Participants included four men (average age = 28.5 years) who had cancer and lived in urban cities in Atlantic Canada. They described infertility after cancer as the paradox of being infertile and the desire to be a father. Three themes emerged from the interviews: (1) How infertility affects me, (2) How infertility affects my relationships, and (3) I want the choice to bank sperm. Infertility touches all aspects of these young men’s lives, challenging their sense of self, relationships and fatherhood goals. The document review showed that fertility services are not distributed evenly across Canada, provincial funding fertility services of sperm banking varies across the provinces and affects men’s decision to bank sperm; and there is limited supportive care for AYA men who experience infertility. Understanding the experiences of infertility among young men after cancer treatment can help healthcare providers design and implement interventions around the issues of sexuality, fertility and fatherhood.
Analysis of upper limb prosthetic and BMI data in Atlantic Canada
(University of New Brunswick, 2014) Manor, Lilian; Biden, Edmund; Hill, Wendy
This research used a quantitative method of approach and the study design was cross sequential in nature and retrospective since data used dates back to 1981. This study examined both the demographics of the total population and anthropometric data from a subset of working age group at the Atlantic Clinic for Upper Limb Prosthetics. The clinic population of 212 clients was adult dominated with the majority being males. Over the years, myoelectric prostheses have become the preferred choice of prosthesis for most of the clinic clients. This study has shown that older clients visited the clinic less frequently for fit issues compared to younger clients and they spent fewer days per clinic visit as well. This study also showed that a high proportion (77.8%) of the clinic subset population with acquired limb loss have BMIs above the overweight border-line indicating the need for more awareness of the health implication of being overweight.
Assessment of dentists' attitudes and practices to provide services in long-term care facilities
(University of New Brunswick, 2016) Abrar, Saira; Montelpare, William
The primary objective of this research was to assess various factors that influence dentists’ attitudes and practices to provide services in long-term care facilities of New Brunswick and Saskatchewan. A survey was sent to all registered dentists in NB and SK through an e-mail that had a web link to access the surveys. The survey questionnaire used for this study was previously validated and used by researchers in two similar studies done in British Columbia. The survey comprised of three parts, first was for the dentists who were currently treating, second part was for those who never treated and third part for those who stopped treating patients in long-term care (LTC) facilities. Two reminders were sent to dentists after the initial survey to increase the response rate. Data analysis was done using Microsoft Excel. The questionnaire was sent to 291 dentists in New Brunswick and 535 dentists in Saskatchewan. A response rate of 15% was achieved as 113 dentists completed the survey. The loss of private practice time and lack of dental equipment and space were the main concerns for all the dentists. The dentists who were currently providing services in LTC facilities did so out of their professional responsibility. The majority of dentists who never treated patients in LTC facilities were not asked for such services and thought that financial incentives were inadequate. The dentists who stopped treating patients in LTC facilities reported administrative difficulties and uncomfortable work environment as the primary reason for not providing services.
Childhood matters: Exploring ACEs and future health outcomes in adults on the waitlist for subsidized housing in New Brunswick
(University of New Brunswick, 2023-12) Pappas, Julia C.; Woodhall-Melnik, Julia
Adverse childhood experiences (ACEs) are said to be the single greatest unaddressed public health threat facing our nation today. This study uses a cross-sectional survey design to measure self-reported ACEs of individuals waiting for subsidized housing in NB (n=205). The relationship between ACEs and self-reported health is also assessed using multilinear regression models; operationalized through depression (CESD-10), psychological distress (Kessler 6), and physical health (EQ VAS, EQ-5D-5L index value). The majority (86.12%) report at least 1 ACE. There are significant inverse associations between ACEs and depression (F(7, 197), p < 0.00, R2 = 0.4) and psychological distress (F(7, 197)= 19.18, p < 0.001; R2 =0.41). There is also a significant negative relationship between ACEs and EQ VAS score (F(7, 197), p < 0.001, R2 = 0.12) and the EQ-5D (F(7, 197)=6.62, p < 0.001, R2 = 0.19). The findings indicate a need for additional support for housing-insecure individuals with experienced ACEs.
Effectiveness of an online game in promoting positive attitudes towards nursing homes among youth
(University of New Brunswick, 2020) Folkins, Cassandra; Read, Emily; Bateman, Scott
Nursing homes in New Brunswick are facing a workforce shortage as a result of a rapidly aging population. In response, the nursing home sector has developed an online video game to promote the sector and engage youth as part of a long-term recruitment strategy. The objective of this research is to evaluate the effectiveness of this game in promoting positive attitudes towards nursing homes among youth. A focus group study was conducted with youth aged 11 – 16 years to examine their experiences playing the game and to discuss any impact the game had on their attitudes towards nursing homes and towards working in nursing homes. Qualitative analysis found two core themes emerged from the focus group data: Game Experience and Perceptions of Nursing Homes. Findings indicate players did experience some positive change in their attitudes towards nursing homes after playing the game. Implications of the findings and study limitations are discussed.
Patient voice: appreciative inquiry into living well with diabetes
(University of New Brunswick, 2013) Burgess, Jean; Clark, Roberta; De'Bell, Keith
This study explores the question "What factors contribute to successful self-management of chronic disease/diabetes from the patients' perspective?" It analyses individual interviews with 13 adults with diabetes about living well with diabetes, and their dreams of enhanced conditions for successful self-management of diabetes. The study has two assumptions: 1) patients have unique, particular, and holistic knowledge of their health and self-management practices, 2) Appreciative Inquiry locates and enhances the positive and life-giving forces in individuals and systems. Appreciative Inquiry is thus seen as an appropriate methodology to use in the discovery of the positive, life-giving attitudes, actions, and dreams of the participants. Thematic Analysis of the interview data identifies that positive personal qualities, reciprocal interpersonal support, and experiential expertise are three themes which interact and enable participants to live well with diabetes. Frank's illness narrative theory is used to frame the quest narrative manifest in the overarching theme, simultaneously embracing diabetes management and life.
Risk factors for Conduct Disorder among Canadian children: a focus on childhood-onset Conduct Disorder
(University of New Brunswick, 2017) Swarna, Hepsi; Yu, Weiqiu
Childhood-onset Conduct Disorder (CD) is a serious mental health issue. Research has shown that when CD affects a child under 10, the problems are more likely to persist as the child grows up. Research has also shown that there are many risk factors associated with CD. However, there have been no known studies conducted for Canada looking exclusively at risk factors for childhood-onset CD. This thesis quantitatively assesses the impact of risk factors identified in the Canadian "National Longitudinal Survey of Children and Youth" (NLSCY): Cycles 1 & 3 on childhood-onset CD using binary response regressions. This research concluded that major risk factors associated with childhood-onset CD in Canada include: being a male, comorbidity with ADHD, low income, low parental education, maternal depression, family dysfunction, hostile/ineffective parenting, yelling at a child often, exposure to violence in home, parental smoking, and mother being very young at the birth of the child.
Smoke-free hospitals: perceptions, experiences and behaviours of healthcare providers
(University of New Brunswick, 2018) Luck, Kerrie, Ellen; Doucet, Shelley
Smoking tobacco is the leading preventable cause of premature disease and death, yet nearly 4.2 million Canadians still smoke despite the gains that have been made in tobacco control (Government of Canada, 2015). Tobacco control initiatives, such as smoke-free hospital properties, have the potential to create opportunities to promote healthy choices, influence how tobacco use is managed, and reduce the use and exposure of tobacco (Shopik, Schultz, Nykiforuk, Finegan, & Kvern, 2012); however, tobacco dependence is often not considered a frontline issue when exploring the impact of tobacco control interventions (Schultz, Bottorff, & Johnson, 2006). The purpose of this study was to explore how the implementation of a comprehensive smoke-free hospital policy influenced the perceptions, experiences, and behaviors of healthcare providers including: perceived roles and behaviors in tobacco dependence treatment; perceived barriers and facilitators to offering tobacco dependence treatment; and the overall perception of workplace culture as it relates to tobacco. The outline for this publication-based dissertation includes: an introduction, two background manuscripts, a research plan outline, one manuscript with the study findings, and a conclusion. The introductory chapter provides context for the dissertation and explains the cohesiveness of the individual manuscripts. The first manuscript explores the background on smoke-free hospital properties to illuminate this important healthcare initiative and to provide a foundation to understand the current climate. The second manuscript examines and applies four commonly used health promotion theories to inform the development of a smoke-free hospital program theory. This was used to enhance awareness of potential influencers for exploration during the research study. A bridging chapter provides the rationale and background on the research design and ethical considerations. The third manuscript provides the main study findings on how the implementation of a comprehensive smoke-free hospital policy influenced healthcare providers’ perceptions, experiences, and behaviors. The four overarching themes include: 1) greater support for tobacco reduction; 2) enhanced patient care and interactions; 3) improved staff morale; and 4) some barriers still exist. The dissertation concludes with a summary of each manuscript related to the field of study, as well as implications for practice, research, education, and policy.
The dynamics of empowerment measures on population health outcome and well-being
(University of New Brunswick, 2018) Ransome-Kuti, Temitope; Audas, Richard; McKenna, Mary
Health disparities among countries remain a significant population health and wellness issue (WHO, 2016). These disparities have continued to expand despite various global initiatives targeting their reduction. A report on the achievement of the Millennium Development Goals (MDGs) by the United Nations (2015) found that even though countries had a standard blue print to implement MDGs, the rate of achieving these MDGs was not proportional across member countries. Empowerment levels are one of the main contributive factors of international disparities. It is hypothesized that an increase or decrease in empowerment can impact population health and well-being (Witvliet, Stronks, Kunst and Arah, 2015). This study explores the dynamics of empowerment measures on population health and well-being from over 170 countries during the period of the MDGs, between 2000 and 2015, while controlling for GDP, education and income inequality. Using descriptive statistical analysis and a multiple linear regression (p ≤ 0.1), we found that countries with high levels of various freedoms had positive significant effects on population health measures and countries with lower levels of freedoms had poor outcomes. However, contrary to expectations, high income inequality countries had higher average life expectancy, the lowest rates of infant mortality, and the highest Happy Planet Index results. Nevertheless, most of the empowerment measures were associated with improved health; thus, greater recognition of the role of empowerment in influencing health and further examination of the mechanisms of influence are warranted.
The effect of empowerment/self determination on population health
(University of New Brunswick, 2015) Kalu, Edna Ikechi; Audas, Richard; Yu, Weiqiu
In the face of the growing gap in health within and between populations, health promotion models have focused on the healthcare system, and more recently the social determinants of health. A less explored idea is the effect of empowerment/self-determination on health. Using published cross-country data and the “general-to-specific” (GETS) algorithm implemented in PcGets (Hendry and Krolzig, 2001), this study found that one standard deviation increase in the level of empowerment is associated with a 0.17 standard deviation increase in all life expectancy, a 0.61 standard deviation increase in female life expectancy, a 0.14 standard deviation decrease in infant mortality, and a 0.09 standard deviation decrease in under 5 mortality; and one standard deviation increase in the level of empowerment is associated with a 0.18 standard deviation increase in all life expectancy, a 0.67 standard deviation increase in female life expectancy, a 0.16 standard deviation increase in male life expectancy, and a 0.2 standard deviation decrease in infant mortality (using political rights and civil liberties freedom respectively) while controlling for wealth, education and income inequality (p ≤ 0.05).
The effect of mental fatigue on the psychobiological response to a 10km cycling time trial: a neuroergonomic approach
(University of New Brunswick, 2016) Connon, Hannah; Scott, David
Mental fatigue is best described as a change in psychophysiological state due to sustained cognitive or perceptual performance. The negative effects of mental fatigue on occupational and cognitive tasks have been well documented (Boksem, Meijman, & Lorist, 2005; Lorist et al., 2000; Lundberg et al., 2002). Few studies exist that examine the effect of mental fatigue on physical performance (Marcora, Staiano, & Manning, 2009; Mehta & Parasuraman, 2014); those that do suggest that mental fatigue negatively affects performance. The purpose of the study was to investigate the effect of mental fatigue on the psychobiological response to exercise, whilst controlling for aerobic capacity, perfectionism, and intrinsic motivation. A neuroergonomic approach was used by implementing Near Infrared Spectroscopy (NIRS) to examine cerebral hemodynamics. Participants (N=50) underwent two phases of testing: an initial screening phase and an experimental phase. A matched grouped design was implemented, randomly assigning participants to either the control or experimental group. The testing phase consisted of either a mentally fatiguing cognitive task, or a neutral control condition, followed by a 10km cycling time trial. Dependent variables were time to completion, heart rate, VO[2 (subscript)] peak power, oxygenated hemoglobin, deoxygenated hemoglobin, total oxygenation index, self-efficacy, and rate of perceived exertion. Data reduction was executed via principle component analysis, resulting in three new factors: performance and central physiological markers, negative peripheral physiological markers, and negative psychological markers. MANCOVA was performed with VO[2max (subscript)], self-orientated perfectionism, and motivation towards physical activity entered as covariates, and group as the only independent variable. Group failed to account for a significant amount of variability in the three factors after the variability shared between the covariates and the factors were controlled for (Pillai’s Trace = 0.19, F[(3, 43) subscript] = 0.275, p > 0.05, partial η[squared] = .019). Contrary to previous research, findings indicate that mental fatigue does not affect the psychobiological response to exercise. However, the sample consisted of predominantly well-trained individuals with similar psychological traits, which could have masked any mediating effects of the covariates. Mental fatigue appears to be a multidimensional construct, where an individual’s perception of mental fatigue is the most influential factor.
The experience of breastfeeding after birth trauma: a phenomenological study
(University of New Brunswick, 2020) Northrup, Erin Crystal; Aquino-Russell, Catherine
Childbirth can be a traumatic experience. Birth trauma is characterized by subjective feelings of horror, intense fear, or helplessness; it can have long term consequences on the parent's health and relationships. The health effects of breastfeeding are well documented, yet the impact of birth trauma on the breastfeeding experience is not well understood. Giorgi's Descriptive Phenomenological Method was used to elucidate the meaning of breastfeeding after birth trauma. Using the Ottawa Charter for Health Promotion as a lens, analysis of written descriptions revealed that breastfeeding after birth trauma encompasses the embodiment of pain and mistreatment, while feeling at the mercy of institutional policies. Participants also described unique support needs amidst opportunities for personal growth. The findings from this research could be used to help healthcare professionals be cognizant of what is important in caring for these individuals in the postpartum period and inform the development of supportive health care policies.
The lived experiences of Middle Eastern immigrant women during their cancer survivorship journey: a phenomenological study
(University of New Brunswick, 2019) Alsrayheen, Enam; Aquino-Russell, Catherine
The number of Middle Eastern immigrant women (MEIW) living in Canada has significantly increased. However, this group of women are under-represented in health research, and there is a gap in knowledge of their cancer survivorship experiences in Canada. This phenomenological qualitative approach was employed to uncover the meaning of the lived experiences of MEIW during their cancer survivorship journey (CSJ). Data were collected through unstructured interviews and one written description from three MEIW. The participants' perspectives of cancer risk factors were believed to be the cause of their cancer and their CSJ was fear-inducing and anxiety-provoking. For the participants, social support, coping, language, information, and cancer care by professionals, as well as cultural beliefs, had significant impacts on this journey. Healthcare professionals need to identify immigrant women's unmet needs of support and psychosocial responses during their CSJ. Language-specific and culturally competent cancer-care intervention programs need development within the Canadian healthcare system.

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Browsing Open Theses & Dissertations by Subject "Applied Health Services Research"

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