Marianne Lamb

Universidade Norte do Paraná

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Christina Godfrey

Queen's University

Margaret B. Harrison

Queen's University

Patricia Oakley

Tharawal Aboriginal

Ian D. Graham

University of Ottawa

Linda Thorne

York University

Rosemary Lysaght

Queen's University

Sandra LeFort

Memorial University of Newfoundland

Alice Gaudine

Memorial University of Newfoundland

Diane Buchanan

Queen's University

Rodrigo Franco de Oliveira

Universidade Evangelica de Goiás

Cooperative Institutions

Universidade Norte do Paraná

Queen's University

Universidade Estadual de Londrina

Queens University

University of Alberta

University of the Free State

University of Newcastle Australia

Ottawa Hospital

University of Ottawa

Universidade Evangelica de Goiás

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Barriers and facilitators to consulting hospital clinical ethics committees

Nursing Ethics (2011)

Alice Gaudine Marianne Lamb Sandra LeFort Linda Thorne

Hospitals in many countries have had clinical ethics committees for over 20 years. Despite this, there has been little research to evaluate these committees and growing evidence that they are underutilized. To address this gap, we investigated the question ‘What are the barriers and facilitators nurses and physicians perceive in consulting their hospital ethics committee?’ Thirty-four nurses, 10 nurse managers and 31 physicians working at four Canadian hospitals were interviewed using a semi-structured interview guide as part of a larger investigation. We used content analysis of the interview data related to barriers and facilitators to use of hospital ethics committees to identify nine categories of barriers and nine categories of facilitators. These categories as well as their subcategories are discussed and those specific to nurses or physicians are identified. The need to increase health professionals' use of clinical ethics committees through reducing barriers and maximizing facilitators is discussed.

Clinical Ethics

Ethics committee

10.1177/0969733011403808

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Citations (34)

Effectiveness of interventions for undernourished older inpatients in the hospital setting

Sandra Capra Clare E. Collins Marianne Lamb Dawn Vanderkroft C. S. Wai-Chi

In health care today, undernutrition or malnutrition among elderly hospitalised patients is a widespread problem resulting in serious or adverse health outcomes. Psychosocial factors contribute to the risk of inadequate nutrition or undernourishment in older adults.2 Many older patients live on fixed incomes, have reduced access to food (social isolation), have poor knowledge of nutrition, or are dependent on others (caretakers or institutions) for food preparation. They may also suffer from depression, bereavement, dementia, or alcohol use. Undernutrition is, however, generally not recognised in treating elderly patients who are in the hospital system. There is evidence to suggest that this condition delays recovery and has the effect of lowering resistance to medical complications. Indeed, studies have demonstrated there is a link between undernutrition and lengthened hospital stay, mortality and morbidity. Malnourished older patients consult their general practitioners more frequently, are in hospital more often and for longer periods, and have higher complication and mortality rates.

Depression

Social Isolation

Isolation

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The psychosocial spiritual experience of elderly individuals recovering from stroke: a systematic review

The JBI Database of Systematic Reviews and Implementation Reports (2008)

Marianne Lamb Diane Buchanan Christina Godfrey Margaret B. Harrison Patricia Oakley

Objectives The objective of this review was to appraise and synthesise best available evidence on the psychosocial spiritual experience of elderly individuals recovering from stroke. Inclusion criteria This review considered qualitative studies whose participants were adults, mean age of 65 years and older, and who had experienced a minimum of one stroke. Studies were included that described the participant's own experience of recovering from stroke. Search strategy The search strategy sought to find both published and unpublished studies and papers, not limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of text words contained in the title and abstract, and of index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Methodological quality Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the Qualitative Assessment and Review Instrument (QARI) developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data collection Information was extracted from each paper independently by two reviewers using the data extraction tool from QARI developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data synthesis Data synthesis aimed to portray an accurate interpretation and synthesis of concepts arising from the selected population's experience during their recovery from stroke. Results A total of 35 studies were identified and of those 27 studies were included in the review. These qualitative studies examined the perceptions of elderly individuals who had experienced a stroke. Findings were analysed using JBI-QARI. The process of meta-synthesis using this program involved categorising findings and developing synthesised topics from the categories. Four syntheses were developed related to the perceptions and experiences of stroke survivors: sudden unexpected event, connectedness, reconstruction of life and life-altering event. Conclusion The onset and early period following a stroke is a confusing and terrifying experience. The period of recovery involves considerable psychological and physical work for elderly individuals to reconstruct their lives. For those with a spiritual tradition, connectedness to others and spiritual connection is important during recovery. The experience of stroke is a life-altering one for most elderly individuals, involving profound changes in functioning and sense of self.

CINAHL

Data extraction

Stroke

10.11124/01938924-200806120-00001

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Measurement of fatigue in chronic obstructive pulmonary disease and in asthma

International Journal of Nursing Studies (2000)

Sandra P. Small Marianne Lamb

Chronic Fatigue

10.1016/s0020-7489(99)00066-8

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Citations (25)

Intervention strategies that support self-care activities: an integrative study across disease/impairment groupings

The JBI Database of Systematic Reviews and Implementation Reports (2010)

Christina Godfrey Margaret B. Harrison Rosemary Lysaght Marianne Lamb Ian D. Graham

The incidence of chronic disease and people with complex chronic medical needs is increasing worldwide. Self-care is an important element for these individuals and can pose challenges both to the recipients and providers of care. Health care professionals seeking evidence on how best to support self-care face challenges finding this research. As a care concept it is typically dealt with clinically and studied relative to specific conditions. The Cochrane Database of Systematic Reviews reports on research across 52 different disease/impairment groupings, with many systematic reviews presenting inconclusive results. Although individual reviews may not offer as much evidence as hoped, it is possible that by synthesizing evidence from multiple reviews that further knowledge and direction about the supportive care professionals can provide for self-care can be found and made available to inform practice.To explore and evaluate the evidence on self-care interventions through a cross-cutting, integrative study.Types of studies: All systematic reviews contained within the Cochrane Database of Systematic Reviews.Participants who were either recently diagnosed with, or currently living with, a disease, disability or impairment. No age stipulation was applied.Types of interventions: Interventions focused on initiating, supporting or enhancing self-care activities.Types of outcomes: The successful engagement of the individual in self-care activities; the sustainment of self-care activities; health outcomes or health care services utilization.The search strategy was designed to find all systematic reviews contained within the Cochrane Database of Systematic Reviews that addressed interventions to initiate or enhance self-care. The Cochrane Library was searched directly though Wiley and through the OVID interface. Keywords and index terms were harvested from key reviews and a second round of searching was performed.Inclusion criteria: Inclusion criteria were guided by Orem's Theory of Self-Care. Reviews were included that addressed health deviation self-care requisites which refer to changes in self-care activities to regulate the effects of deviation from normal structure or function.Interventions were examined within the context of knowledge translation, using the Knowledge-to-Action framework by Graham and colleagues. Interventions were grouped into one of two sections in the framework: a) the adaptation to a specific population, or b) the sustainment of knowledge use.Outcomes were classified according to the Knowledge Use and Impact framework by Graham and colleagues. This framework categorizes outcomes in terms of what is being measured (knowledge; use of knowledge) as well as the impact of the use of that knowledge (patient/ individual; provider or system outcomes).Assessment of methodological quality: Methodological quality was assessed using the JBI Critical Appraisal Checklist for Systematic Reviews. A cut-off point of 7/10 was established.Data were extracted from the systematic reviews using an adaptation of the standardized data extraction form, the JBI Data Extraction Form for Systematic Review of experimental/ Observational Studies.Study results were synthesized and discussed in narrative form.Thirty reviews were included in the analysis spanning 16 different disease/impairment groupings and representing a total of 91,170 participants. The most commonly reported intervention strategies were educational sessions (26 reviews) and self-care management plans (11 reviews), and 27 reviews assessed multiple intervention strategies. Twenty-one reviews reported statistically significant results.There is an emerging body of evidence for effective self-care. This study identified two strategies (educational sessions and self-care management plans) that could be used generically as supportive care by professionals as they assist individuals with self-care.The use of multiple strategies, including educational sessions and self-care management plans have been identified as options that may be effective to support adoption and sustainment of self-care activities.This study highlighted the pervasive problem of heterogeneous data at the primary research level preventing the effective synthesis of current evidence. Further research to standardize the type of outcome measured and the method of measurement would advance our ability to determine 'best practices' with self-care. Cochrane systematic review authors reported their systematic review methodologies in varying degrees of detail. Also of note was the range of different methods to assess risk of bias.

10.11124/01938924-201008330-00001

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Citations (6)

Managed Care: What Is It, and Can It Be Applied to Canada?

University of Toronto Press eBooks (1992)

Marianne Lamb Raisa Deber

10.3138/9781442653672-023

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Citations (1)

Ethical conflicts with hospitals: The perspective of nurses and physicians

Nursing Ethics (2011)

Alice Gaudine Sandra LeFort Marianne Lamb Linda Thorne

Nurses and physicians may experience ethical conflict when there is a difference between their own values, their professional values or the values of their organization. The distribution of limited health care resources can be a major source of ethical conflict. Relatively few studies have examined nurses' and physicians' ethical conflict with organizations. This study examined the research question ‘What are the organizational ethical conflicts that hospital nurses and physicians experience in their practice?’ We interviewed 34 registered nurses, 10 nurse managers, and 31 physicians as part of a larger study, and asked them to describe their ethical conflicts with organizations. Through content analysis, we identified themes of nurses' and physicians' ethical conflict with organizations and compared the themes for nurses with those for physicians.

10.1177/0969733011401121

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Citations (48)

Education: What Should Change in Nursing Education over the Next Five Years? Revitalize Education - Agency Partnerships

Nursing leadership (2003)

Marianne Lamb

10.12927/cjnl.2003.16260

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Citations (4)

The importance of peripheral blood films.

PubMed (1992)

Marianne Lamb John Cinicola

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Psychosocial Spiritual Experience of Elderly Individuals Recovering from Stroke

JBI Library of Systematic Reviews (2005)

Christina Godfrey Marianne Lamb Diane Buchanan Margaret B. Harrison

Objectives To conduct a systematic review to determine the best available evidence on the psychosocial spiritual experience of elderly individuals recovering from stroke. Questions The specific review questions to be addressed are: • How do elderly individuals who have had a stroke perceive the recovery process? • What is the psychosocial and spiritual experience of elderly individuals following a stroke? • What are the major concerns of elderly individuals in the first six months following a stroke, in either hospital or community settings? • What are the major concerns of elderly individuals six months to two years following a stroke? Criteria for considering studies for this review Types of participants This review will include studies whose participants are adults, age 65 years and older, in any setting, who have experienced a minimum of one stroke. Experiences within the 2 years post stroke recovery period must be reported by the stroke survivors themselves. Types of interventions Studies will be included if the focus of the study is a description of the participant’s experience in response to a particular intervention. Studies will also be included that describe the participant’s experience of recovering from stroke where no intervention has been introduced. Types of outcome measures Outcomes of interest are the participant’s own experience through self-report. Reports from family and care-givers will be excluded. Types of outcomes will include sense of hope/hopelessness, connection/disconnection with others, disruptions in sense of self and experience of time, loss, independence/dependence, discontinuity with previous way of life, sense of control.

Stroke

10.11124/jbisrir-2005-688

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