Hi Everyone,

Excellent work in week 1. You now have developed the research question that you will work to address throughout this course. You have also started the TCPS2 training.

A common experience when reviewing different theories and frameworks that we could use to help guide, understand or to address the research problem/issue is that we often find that multiple approaches may fit. When this happens it is an opportunity to use our critical thinking to reflect how the different theories/frameworks could help to address our research question. Having a clear and specific research question is very helpful to narrow down our selection. This is helpful to generate quality outcomes from the research and prevent the research from going down ‘rabbit holes’.

I look forward to learning about the framework/theory that best fits with your research question.

Jen C.

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Research Question: How can short periods of compassion-based responsive behaviors by non-family member caregivers help support mental wellness in older adults residing in LTC?

The Coming Back to Existence Caring Model by Lotfi et al., (2020) best fits my research question. The model seeks to improve the level of inner satisfaction of the individual in all dimensions (Lotfi et al., 2020). To a great extent, mental wellness involves a certain measure of inner fulfillment by a human being (Smolcic et al., 2016). Supporting the mental wellness of older adults residing in LTC is very important. Non-family member caregivers (for example nurses, personal support workers, dietitians and others) have a crucial role to play regarding this. Most especially, because older adults in LTC spend a great part of their day in contact with non-family member caregivers either directly or indirectly. The Coming Back to Existence Caring Model might help answer my research question because of its vector approach that draws upon the foundational principle of the nursing process. With this model, multidisciplinary care teams could be empowered to develop person-centered plans of care that would allow for short periods of compassion-based responsive behaviors by non-family member caregivers to help support mental wellness in older adults residing in LTC (Dempsey, 2018; Smolcic et al., 2016).
References
Dempsey, C. (2018). 56 seconds to connect with your patient. https://info.pressganey.com/videos/56-seconds-to-connect-with-your-patient

Lotfi, M., Zamanzadeh, V., Khodayari‐Zarnaq, R., & Mobasseri, K. (2021). Nursing process from theory to practice: Evidence from the implementation of “Coming back to existence caring model” in burn wards. Nursing Open, 8(5), 2794–2800. https://doi.org/10.1002/nop2.856

Smolcic, E., Mavandadi, S., Streim, J.E., &Oslin, D.W. (2016). The association between caregiver-care recipient relationship and caregiver burden and depressive symptoms among community-dwelling older adults with dementia. The American Journal of Geriatric Psychiatry, 24 (3), S104-S105. https://www.ajgponline.org/article/S1064-7481(16)00108-1/abstract

Research question: What nursing interventions can be utilized to increase willingness to participate in personal care for residents in long-term care with dementia?

I enjoyed reading about The Dreyfus Model of Skill Acquisition in the article “From Novice to Expert” this week. This framework stood out to me since I consider myself a novice nurse being that I am currently enrolled in a Practical Nursing program.

I picked this framework because my question was inspired by my first clinical placement and the patterns I observed with residents refusing important personal care seemingly out of fear and anxiety. While many experienced nurses may think that the interventions for assisting this population with personal care are obvious, to me, it is a very new concept and it is a skill I need to develop. For this reason, it seemed like a natural fit to focus on a framework that has the words “skill acquisition” in the name.

This framework has stages that a nurse moves through to acquire a skill. I like that this framework takes into account the nuance of mastery of a nursing skill. While I may be able to digest the isolated procedures and rules of the skill of providing personal care, the framework proposes that the nurse can develop their own nuanced methods based on exposure to novel experiences.

I am eager to learn more about applying these frameworks to actual research.

Thank you!
Rachel

PS I could not access the “Watch Frameworks for Success” video

Research question: What interventions can nurses implement in promoting reduction of incontinence episodes amongst older adults living in long-term care homes?

The framework that I believe resonates with my research question was Health Quality Ontario’s QI Framework RE-AIM. Each of the phases is iterative and designed to build on knowledge gained in the previous phase . 1. Getting Started 2. Defining the problem 3. Understanding Your System 4. Designing Testing Solutions 5. Implementing and Sustaining Changes 6. Spreading Improvement (Health Quality Ontario , April 2013). A simplified diagram which lays out the above phases is called the Model of Improvement. The three phases in that diagram are : AIM-what are we trying to accomplish ? MEASURE- how do we know that a change is an improvement? and CHANGE -what change can we make that will result in an improvement ?. (Health Quality Ontario, p.6).In regards, to my research question the AIM- would be promoting reduction in incontinence episodes amongst older adults living in long – term care homes. The MEASURE-By staff from all shifts collaborating in terms of effective documentation, shift reporting , and DOS monitoring. CHANGE-Interdisciplinary team including the resident because person – centered care should always be applied regardless if the resident is cognitive or not. As a team everyone can bring forth ideas which can develop interventions to better help the resident.