LA #10 – Dissemination Plan

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The utilization of research plays an important role in nursing knowledge and it is essential for the continued improvement of patient care.  It has become apparent that it is one of the most successful ways to develop evidence practice (EBP) to enhance the quality of care that nurses provide to patients (Potter & Perry, 2014). There are many challenges that occur in translating research findings into evidence-based clinical practices. Thus, requires a dissemination plan to successfully transfer findings into practice (LoBiondo et al., 2013; Kerner et al., 2005). Dissemination is a form of communicating findings and focuses on understanding ways to implement an EBP by allowing other researchers to explore what is known about nursing interventions and the impacts the findings will have on the patient’s outcome (Tabak, Khoong, Chambers, & Brownson; Oermann et al., 2008). The utilization of a finding from research in a practice setting is crucial and heavily dependent on a well-informed nursing research study.

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It is evident that mental health is one of the most significant demographic trends that require a prioritized necessity because they suffer a high rate of sickness and comorbidity, which affect their quality of life ((Thomson, Chaze, George, & Guruge, 2015; Islam & Oremus, 2014). Many immigrants have an insufficient amount of information regarding mental health services for the fear of stigma and a lack of mental health care services in their countries (Thomson et al., 2015; Islam & Oremus, 2014). There are many literatures on mental health issues among immigrants and the struggles they face moving into a new country in dealing with stressors that lead to ineffective mental health function. However, there has not been enough light shed on a specific ethnic community issue with mental health. Therefore, the study sets out to explore the lived experience of mental health issues among Ghanaian-Canadian immigrants. The study is very significant in its approach as it provides a good foundation and ethnic context for health care professionals to be culturally sensitive and culturally aware of this community’s values and beliefs concerning mental health. When nurses are aware, they will be able to provide culturally competent care to families from this cultural background because mental health is a huge concern within the Ghanaian-Canadian community.

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Disseminating requires an in-depth strategy which includes: Publications, conference consultation and training programs (LoBiondo et al., 2013). Therefore, the dissemination plan of the findings in this study will employ several strategies. These strategies will include building an alliance with clinicians and stakeholders to enable supportive and critical discussion of findings and their implications by presenting at conferences and attending policy meetings (Powell et al., 2012). This will strengthen the awareness of mental health among immigrants and help to build networks in implementing the study findings. Another strategy will include creating awareness and gaining exposure by developing summaries in a simplified way for readers (LoBiondo et al., 2013; Powell et al., 2012). This can be accomplished by utilizing social media networks such as Facebook, YouTube, websites, and blogs. This strategy can assist in circulating of the findings and provide an accessibility to educate the public and create awareness of mental health issues within the Ghanaian-Canadian immigrants. Another strategy will include sharing the journey of interventions and finding via a journal of nursing articles, institutional newsletters, and cultural events to help them overcome the stigma and lack of education that surrounds mental health. This action will help nurses to gain an awareness of research findings that might be relevant to this community’s unique needs and promote the growth of EBP by publishing research reports written for clinicians (Powell et al., 2012; Oermann et al., 2007). Lastly, provide training seminars in the implementation of the findings to clinicians (Powell et al., 2012).

Reference

Potter, P.A., & Perry, A. G., Stockert, P. A., & Hall, A. M. (2014). Canadian Fundamentals of Nursing (5th Ed.).  (pp. 254, 266). Toronto, ON: Elsevier Canada.

Powell, B. J., McMillen, J. C., Proctor, E. K., Carpenter, C. R., Griffey, R. T., Bunger, A. C., & York, J. L. (2012). A compilation of strategies for implementing clinical innovations in health and mental health. Medical care research and review69(2), 123-157.

Islam, F. & Oremus, M. (2014). Mixed methods immigrant mental health research in Canada: A systematic review. Journal of Immigrant Minority Health. 16(1), 1284-1289.

Kerner, J., Rimer, B., Emmons, K., Kerner, J., Rimer, B., Emmons, K., & Emmons, K. (2005). Introduction to the special section on dissemination-dissemination research and research dissemination: How can we close the gap? Health Psychology, 24(5), 443-446. doi:10.1037/0278-6133.24.5.443.

LoBiondo-Wood, G., & Haber, J. (2013). Nursing research in Canada: Methods, critical appraisal, and utilization (3rd ed.). Toronto, ON: Mosby Elsevier.

Oermann, M. H., Nordstrom, C. K., Wilmes, N. A., Denison, D., Webb, S. A., Featherston, D. E., & Kowalewski, K. (2008). Dissemination of research in clinical nursing journals. Journal of Clinical Nursing, 17(2), 149-156. doi:10.1111/j.1365-2702.2007.01975.x.

Tabak, R. G., Khoong, E. C., Chambers, D. A., & Brownson, R. C. (2012). Bridging research and practice: Models for dissemination and implementation research. American Journal of Preventive Medicine, 43(3), 337-350. doi:10.1016/j.amepre.2012.05.024.

Thomson, M., Chaze, F., George, U., & Guruge, S. (2015). Improving immigrant populations’ access to mental health services in Canada: A review of barriers and recommendations. Journal of Immigrant and Minority Health, 17(6), 1895-1905. doi:10.1007/s10903-015-0175-3

 

LA #5- ETHICS

ethics

Research has played an important role in nursing and has become one of the most successful ways to develop knowledge base into practice in enhancing the quality of care that nurses provide to patients (Potter & Perry, 2014). Nurses come across many ethical dilemmas which may make it difficult to morally decide on the correct action to take, but by understanding the ethical principles in theory and following professional guidelines with experience helps in making ethical decisions and ensure patients are receiving the care and treatment which is morally right (Potter & Perry, 2014). Therefore, it is important that researchers must be aware of the ethical standards to maintain an ethical outlook that respects the dignity and preserve the well-being of all research participants (Potter & Perry, 2014). Based on this ideology, the Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, & Social Sciences and Humanities Research Council of Canada (2014) has put forth a research ethics board (REB) to scrutinize all research proposals and determine if they are following the ethical principles (Potter & Perry, 2014).

The Tri-Council Policy Statement (TCPS) has outlined three guiding ethical principles for human dignity in research involving humans’ participants, which include: Respect for persons, concern for welfare, and justice (Canadian Institutes of Health Research et al., 2014, p.6).  Respect for persons requires the welfare and integrity of the participant to take precedence over the research study (Canadian Institutes of Health Research et al., 2014). The right for persons includes: Recognizing the obligation to respect the individual’s autonomy and the right to make informed decisions about study participation and ensured that dignity is valued to all participants including vulnerable people which are children, cognitive impaired, or people with mental health issues (Canadian Institutes of Health Research et al., 2014). Concern for welfare entails researchers to protect and promote the welfare of participants from bodily to mental and spiritual well-being and ensures that participants are not in any risks (Canadian Institutes of Health Research et al., 2014). And lastly, justice which reflects the importance of treating people equal with respect and concern, as well as distributing the benefits and burdens of research participation equally so that no participants is cheated or discriminated to the benefits of research (Canadian Institutes of Health Research et al., 2014).

This ethnography of qualitative study will consist of participants in a face-to-face interview of a household with a nationality from Ghana or persons who self-identified as a Ghanaian-Canadian immigrant. The exclusion criteria will include anyone born in Canada with no Ghanaian descent and ages below 18 years, Ghanaian immigrants who have resided in Canada past 5 years, and individuals who do not live in Toronto, Ont. In recruiting for participants, a purpose sampling of forty people including both males and females ages 18 and older will be used to recruit participants by going to social-settings such as Ghanaian churches or cultural events to ask for their contribution to the study. Participants will be provided an adequate information regarding the research, process the information and be given the power of free choice to decide if they will participate in the study or not. A well written signed consent will include: the purpose of the study, expectations of participants, the potential risks or benefits and the voluntarily signature of participants will be obtained prior to starting the study. A promise of confidentiality will be ensured to participants by using only initials, all information obtained will be securely stored on a computer with password and information will only be accessible to individuals who are involved in the research. To ensure justice for all participants, the study will be fair throughout. For instance, there will be a non-discriminatory selection of participants, no ill attitude towards individuals who refuse to participate or withdrawing from the study, and moments of debriefing will be provided whenever necessary to ensure clarity to participants. In doing this, it will allow for all individuals to feel equal and free to participate and not be coerced into the study.

This study will contribute to the knowledge base in practice and assist health-care professions in providing culturally competent care and be aware of this community’s values and belief’s concerning mental health. Although, there are many studies of mental health on immigrants and mental health (Guruge, Thomson, George, and Chaze, 2015; Han, Han, Luo, Jacobs, & Jean-Baptiste, 2013; Robert, & Gilkinson, 2012; Thomson, Chaze, George & Guruge, 2015). There is a dearth of literature on the Ghanaian community’s issues with mental health and requires to be addressed. Therefore, this research is to provide a better understanding of the origin of cultural background’s values and beliefs of mental health functioning in the Ghanaian-Canadian community. As well as providing a good foundation and culturally sensitive context for health care professionals in providing culturally competent care to this community by being aware of their values and beliefs concerning mental health (Guruge et al., 2015; Thomas et al., 2015).

Reference:

Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada. (December 2014). Tri-Council policy statement: Ethical conduct for research involving humans.Retrieved from http://www.pre.ethics.gc.ca/pdf/eng/tcps2-2014/TCPS_2_FINAL_Web.pdf 

Guruge, S., Thomson, M., Geroge, U., Chaze, F. (2015). Social support, social conflict, and immigrant women’s mental health in a Canadian context: a scoping review. Journal of psychiatric and mental health nursing. 22(1), 655-667.

Han, X., Han, X., Luo, Q., Jacobs, S., & Jean-Baptiste, M. (2013). Report of a mental health survey among Chinese international students at Yale University. Journal of American College Health, 61(1), 1-8.

Robert, AM. & Gilkinson, T. (2012). Mental health and well-being of recent immigrants in Canada: Evidence from the Longitudinal survey of Immigrants to Canada. Citizenship and Immigration Canada, 1-27

Potter, P.A., & Perry, A. G., Stockert, P. A., & Hall, A. M. (2014). Canadian Fundamentals of Nursing (5th Ed.).  (pp. 254, 266). Toronto, ON: Elsevier Canada

Thomson, M., Chaze, F., George, U., & Guruge, S. (2015). Improving immigrant populations’ access to mental health services in canada: A review of barriers and recommendations. Journal of Immigrant and Minority Health, 17(6), 1895-1905. doi:10.1007/s10903-015-0175-3

LA #4-Purpose, Problem & Questions

Mental health issues in immigrants are becoming a major concern in Canada (Thomson, Chaze, George & Guruge, 2015). The rate of immigrants in the Canadian population continues to increase and has become problematic in public health due to their continues deterioration of mental health (Islam & Oremus, 2014; Subedi & Rosenberg, 2014). Canada has become a home to many immigrants across the globe and among those immigrants are Ghanaians. An outlined by Statistics Canada (2016), shows a growth rate of 10% of Ghanaian immigrants in Canada population. According to Citizenship and Immigration Canada, poor mental health among immigrants is estimated at 5.95% and 7.04%, which is lower than the Canadian-born population (Robert & Gilkinson, 2012). Currently, it is estimated that 1 million Canadians live with mental illness and up to 1 in 5 Canadians will encounter mental health issues in their lifetime (Halter, Pollard & Jakubec, 2014). Therefore, it is important to pay special attention to these aggregate unique needs because they are faced with numerous physical, psychological, and social role changes that challenge their mental health status (Han, Han, Luo, Jacobs & Jean-Baptiste, 2013).

Researchers have identified that, after migrating to Canada, many immigrant’s health continues to decline due to the hardships and stressors they endure in Canada (Islam & Oremus, 2014; Thomas et al., 2015). Stressors such as underemployment, adapting to a new culture, racialization, discrimination and family separation/social isolation have been a contributing factor that affects the immigrant’s mental health status (Han et al., 2013; Thomson et al., 2015; Guruge et al., 2015). These challenges that immigrant faces daily affects their optimal mental health and result in anxiety, isolation, and alienation within their community (Han et al., 2013; Guruge et al., 2015). Many immigrants have an insufficient amount of information regarding mental health services due to a lack of mental health care services in their countries, fear of stigma for accessing services, or a lack of culturally appropriate services in Canada (Han et al., 2013; Thomas et al., 2015). As this confirms that many Ghanaians in Canada lacks the knowledge on the importance of mental health well-being due to the fact they were raised in an environment whereby they have not been introduced to poor mental health function as an issue. The consequences of immigrants’ challenges in accessing health care and being unaware of mental health resources available to them result in underutilization of mental health services and viewed as a health inequity within the immigrant population which needs to be addressed (Thomson et al., 2015). There are various studies of mental health on immigrants that focuses on the struggles of moving into a new a country and dealing with stressors that leads to ineffective mental health function in many (Guruge, Thomson, George, and Chaze, 2015; Han, Han, Luo, Jacobs, & Jean-Baptiste, 2013; Robert, & Gilkinson, 2012; Thomson, Chaze, George & Guruge, 2015). However, does not narrow down to specific ethnical backgrounds (Thomas et al., 2015; Han et al., 2013; Robert & Gilkinson, 2012). Based on the dearth of literature on mental health of Ghanaian-Canadian community, this study seeks to examine the perception and beliefs of mental health in Ghanaian-Canadian immigrants. The purpose of this ethnography qualitative study is to examine the perception and beliefs of mental health in the Ghanaian-Canadian immigrants and how mental health influenced their culture. The goal is to provide a knowledge base of this community’s values and belief’s concerning mental health base to assist nurses in providing culturally sensitive competent care and being culturally aware. The following questions will be used as a guide in the interview process: (1) What are your beliefs and perception of mental health? (2) How does your culture or religion impact your views on mental health? And (3) How do you cope with stressors in your life and how do you manage stressors? This will allow the researcher to gain more understanding from this cultures lived experience of mental health (LoBiondo et al., 2013).

Rough Draft:

Methodology: Qualitative method by using an ethnographic approach it allows the researcher to gain a holistic view in understanding the meaning and experiences of the Ghanaian community culture (LoBiondo-wood et al., 2013).

Goal: The goal is to provide a knowledge base of this community’s values and belief’s concerning mental health base to assist nurses in providing culturally sensitive competent care and being culturally aware.

Population: Ghanaian-Canadians immigrants living in Canada.

Sample: In-depth interactions, interviews, purposeful and small sampling in Ghanaian-community churches in Toronto.

Data collection methods: Face-to-face interviews, tape-recorded, videotaping and note taking to gather participants responses in a small group session (LoBiondo-Wood et al., 2013). A written consent will be obtained from all participants.

Analysis strategy:  Quasi-statistical analysis which includes: using thematic analysis; interpretative approaches and conversation analysis to gather and sort data on participant’s responses to the research questions (Noble & Smith, 2014).

Presentation: Essay

References:

Guruge, S., Thomson, M., Geroge, U., Chaze, F. (2015). Social support, social conflict, and immigrant women’s mental health in a Canadian context: a scoping review. Journal of psychiatric and mental health nursing. 22(1), 655-667.

Halter, M. J., Pollard, C.L., Jakubec, S.L. (2014). Varcarolis’s Canadian psychiatric mental health nursing: A clinical approach (2nded.). Milton, ON: Elsevier Canada.

Han, X., Han, X., Luo, Q., Jacobs, S., & Jean-Baptiste, M. (2013). Report of a mental health survey among Chinese international students at Yale University. Journal of American College Health, 61(1), 1-8.

Islam, F. & Oremus, M. (2014). Mixed Methods Immigrant Mental Health Research in Canada: A Systematic Review. Journal of Immigrant Minority Health. 16(1), 1284-1289.

Robert, AM. & Gilkinson, T. (2012). Mental health and well-being of recent immigrants in Canada: Evidence from the Longitudinal survey of Immigrants to Canada. Citizenship and Immigration Canada, 1-27

Statistics Canada. (2017, Nov). Immigration and Ethnocultural Diversity Highlight Tables. Retrieved from https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/hlt-fst/imm/Table.cfm?Lang=E&T=31&Geo=01

Subedi, R. P., & Rosenberg, M. W. (2014). Determinants of the variations in self-reported health status among recent and more established immigrants in canada. Social Science & Medicine, 115(Complete), 103-110. doi:10.1016/j.socscimed.2014.06.021

LoBiondo-Wood, G. & Haber, J. (2013). Nursing research in Canada: Methods, critical appraisal, and utilization (3rd ed.). Toronto, ON: Mosby Elsevier.

Noble, H., & Smith, J. (2014). Qualitative data analysis: A practical example. Evidence – Based Nursing, 17(1), 2. doi:http://dx.doi.org.librweb.laurentian.ca/10.1136/eb-2013-101603

 

 

 

 

REVISED LA #3

Based on the feedback provided, I have decided to redirect my research topic to Ghanaian-Canadians perception of mental health. Mental health is the function of our emotional, psychological and social well-being which affects how we think, feel and act (Halter, Pollard & Jakubec, 2014). There are a lot of information on mental health literature on immigrant’s mental health. However, I feel that there has not been enough light shed on the Ghanaian community’s issues with mental health. The research found on mental health in immigrants focuses on the struggles moving into a new country and dealing with stressors that lead to ineffective mental health function in many immigrants. Individuals who are from Ghana have been raised in an environment whereby they have not been introduced to poor mental health function as an issue. Han, Han, Luo, Jacobs, & Jean-Baptiste (2013) supports this statement that immigrants may not be familiar with the concept of mental health. As this confirms that many Ghanaian Canadian in this country came here as immigrants and do lack the knowledge on the importance of mental health well-being. They believe that an individual’s mental health state should always be intact because their religion, values, and beliefs take precedent over their holistic health. This notion has an impact on generations from this cultural background’s values and beliefs of mental health functioning. Which is evident as their parents have imposed their values and views on how they should adapt to their mental health state. As being an immigrant myself, the views on mental health by my parents growing up has impacted me in so many ways. Because being in nursing school I have to learn to adjust to the western world’s view of mental health and acceptance of mental illness. Ghanaians presume mental illness as a stigma, so it prevents them from seeking help for it. Which also inhibits the acceptance of an affected person in the community if an individual is affected by a mental illness. Many immigrants leave their country in the pursuit of a better quality of life in the western world but fail to realize that there are conflicts they may encounter in their new environment (Han, Han, Luo, Jacobs, & Jean-Baptiste, 2013). They encounter challenges such as adjusting to new social status, lifestyle changes, barriers to accessing health services, poor social determinants of health, work-related stress, discrimination, and unfair treatment. Therefore, nurses need to be culturally sensitive and culturally aware of this community’s values and belief’s concerning mental health (Guruge, Thomson, George, and Chaze, 2015). When nurses are aware, they will be able to provide culturally competent care to families from this cultural background because mental health is a huge concern within the Ghanaian Canadian community, however, it does not get addressed.

 

References

Guruge, S., Thomson, M., Geroge, U., Chaze, F. (2015). Social support, social conflict, and immigrant women’s mental health in a Canadian context: a scoping review. Journal of psychiatric and mental health nursing. 22(1), 655-667.

Halter, M. J., Pollard, C.L., Jakubec, S.L. (2014). Varcarolis’s Canadian psychiatric mental health nursing: A clinical approach (2nded.). Milton, ON: Elsevier Canada.

Han, X., Han, X., Luo, Q., Jacobs, S., & Jean-Baptiste, M. (2013). Report of a mental health survey among Chinese international students at Yale University. Journal of American College Health, 61(1), 1-8.

LA #3

After a thorough research, I have finally decided that my final project for nursing inquiry and Praxis III will be a literature review on the experience of being a spouse caregiver of a dying person. Although, there are various research in spouse caregiver burnouts, there are limited resources for the aftermath of the death. Sadly, we see this often when a spouse becomes a caregiver to the dying person and neglect’s their own existence by making their spouse a priority by forgetting that there is life after the person is gone. My aim is to acquire knowledge and resources on the effects of a spouse dedicating themselves to a dying person and what happens after the person passes on. How do the person move on with their lives? This can be beneficial in nursing by providing more insight into this problem, as well as providing holistic care to the family members of the dying one.