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For many novice teachers, their first year on the job can be a roller coaster experience of 'ups' and 'downs' as they transition from their teacher education programs to teaching in real classrooms. While to 'ups' are always good to experience, the 'downs' can be so traumatic that novice teachers can feel so stressed that their teaching is adversely impacted and burned out to the point that they consider resigning for the profession. For the most part, however, the language teaching profession has not addressed this aspect of a novice ESL (English as a second language) teacher well-being in terms of their personal and emotional investment as they transition from trainee to novice teacher in their first year. This paper attempts to shed light on the emotional experiences of three female novice ESL teachers in a university language school in Canada as they reflected during regular group discussions and journal writing during their first semester (12 weeks) as novice ESL teachers. The results reveal that the group discussions and journal writing provided a platform for the teachers to articulate their mostly negative emotions with three most frequently expressed: frustration, anger and boredom. [ABSTRACT FROM AUTHOR]

Food insecurity is widely documented among people living with HIV (PLWH) worldwide, and it presents significant challenges across the spectrum of HIV care and support. In North America, the prevalence of food insecurity among PLWH exceeds 50%. In the province of British Columbia (BC), it exceeds 65%. It comes as no surprise that food has become an essential tool in supporting and engaging with PLWH. Over the past decade, however, a shift has taken place, and food has become an incentive to boost uptake and outcomes of prevention, testing, treatment, and support. To explore this practice, we drew on a qualitative case study of incentives in the care and support of PLWH. This paper presents the findings of a targeted analysis of interviews (N = 25) that discuss food incentives and explores two main themes that shed light on this practice: (1) Using food to engage versus to incentivize and (2) Food is more beneficial and more ethical. Providers perceived food more positively than other incentives, despite the goal remaining somewhat the same. Incentives, such as cash or gift cards, were considered ethically problematic and less helpful (and potentially harmful), whereas food addressed a basic need and felt more ethical. [ABSTRACT FROM AUTHOR]

Drawing on qualitative data collected during the first phase of an intervention-research, this study explores the concept of "social-ecological transition" (SET) from the perspectives of youth eco-activists. As a multi-level approach to intersecting social and ecological crisis, this notion has yet been examined from a social work viewpoint and limited knowledge is available regarding how it is being appropriated and envisioned in nonscientific spaces. Considering the need to increase youth participation in ecosocial work and climate governance, youth eco-activists from Canada (N = 10) were interviewed to explore their definitions of the SET and to better understand youth-specific issues related to climate change and climate action. A focus group was conducted with five of those same youth and aimed to foreground their experiential knowledge to collaboratively refine the ecosocial component of a sport and nature-based program, implemented at a subsequent phase of the research. Findings show that youth focus especially on socio-cultural elements of the transition, therefore expanding current understandings of the SET. Three main components are mapped-out (Intersectional climate justice, Intergenerational allyship, Place-based connections) and reveal that collaborations, solidarities, and connections are at the heart of eco-activists' narratives. Key considerations for ecosocial work practice are discussed by centering youth voices, thus showcasing the need for increased experiential learnings to (re)connect with nature and community. The concept of relational ecological justice is proposed to capture a nuanced, non-dichotomic position concerning the ecocentrism/anthropocentrism debate, an approach that invites to renegotiate the ontological boundaries of ecosocial work. [ABSTRACT FROM AUTHOR]

Tuberculosis health care workers (TB HCWs) in low incidence settings have important perspectives on providing TB education and counselling to patients and family members born in other countries. The purpose of this qualitative study was to explore HCWs' perspectives on barriers and facilitators for capacity-building education and counselling with patients and family members born outside of Canada experiencing advanced infectious TB in Calgary, a city in western Canada. Data were collected through semi-structured interviews and field notes and thematically analysed. Twenty-four HCWs representing clerical staff, nurses, physicians, and allied health professionals employed in TB care were interviewed. HCWs described how multi-level barriers such as patients' fear of death, complex intra-family communication, information-laden appointments, and patients' precarious employment collided resulting in overwhelmed patients and reduced connection to family. Some HCWs were unsure how to discuss TB stigma with patients and family members. HCWs perceived that increased continuity of care and providing patients and family members with digestible amounts of information earlier were important steps towards better practice. HCWs identified that patients and families could benefit from preparation for initial appointments, increased continuity, and improved patient education materials. HCWs should also receive skills-training to facilitate individual and family counselling. [ABSTRACT FROM AUTHOR]

In 2016, Canada joined many jurisdictions worldwide in legalizing Medical Assistance in Dying (MAiD). Given the paucity of qualitative research regarding the involvement of interprofessional health care providers (HCPs) in MAiD, the goal of this study was to better understand how HCPs viewed their role(s). Semi-structured interviews were conducted with 3 pharmacists, 10 nurses, and 8 social workers at an academic hospital in Toronto. Thematic analysis generated six broad themes: 1) Practical/Technical Component, 2) Education, 3) Support, 4) "Part of the Job," 5) "All of the Job," and 6) Lack of Published Information. While nurses and social workers espoused many commonalities, nursing roles were more "in the moment," whereas social workers viewed their roles as beginning earlier and extending after provision of MAiD. There was a spectrum of how participants perceived their role: pharmacists minimized the task of dispensing medications as an insignificant experience, nurses viewed involvement as consistent with their other professional duties (specifically non-MAiD deaths), and social workers described MAiD as a unique opportunity to employ the full gamut of their skills. The study highlights the importance of supporting HCPs through education and information at both regulatory and research levels, recognizing the key roles they play in MAiD. [ABSTRACT FROM AUTHOR]

Essential family caregivers (EFCs) of relatives living in long-term care homes (LTCHs) experienced restricted access to their relatives due to COVID-19 visitation policies. Residents' experiences of separation have been widely documented; yet, few have focused on EFCs' traumatic experiences during the pandemic. Objective: This study aims to explore the EFCs' trauma of being locked out of LTCHs and unable to visit their loved ones in-person during COVID-19. Seven online focus groups with a total of 30 EFCs from Ontario and British Columbia, Canada were conducted as part of a larger mixed-method study. We used an inductive approach to thematic analysis to understand the lived experiences of trauma. Four trauma-related themes emerged: 1) trauma from prolonged separation from loved ones; 2) trauma from uncompassionate interactions with the LTCH's staff and administrators; 3) trauma from the inability to provide care to loved ones, and 4) trauma from experiencing prolonged powerlessness and helplessness. The EFCs experienced a collective trauma that deeply impacted their relationships with their relatives as well as their perception of the LTC system. Experiences endured by EFCs highlighted policy and practice changes, including the need for trauma-centred approaches to repair relational damage and post-pandemic decision-making that collaborates with EFCs. [ABSTRACT FROM AUTHOR]

To determine the knowledge and confidence of physiotherapists in managing knee osteoarthritis (OA) and patellofemoral pain (PFP); and explore their learning behaviors and preferences related to the management of these knee conditions. One hundred and sixteen Australian and Canadian Physiotherapists were recruited via social media, e-mail, and an online course. Part 1: Quantitative involved an online survey evaluating knowledge of evidence and confidence in providing treatments for knee OA and PFP. Part 2: Qualitative involved semi-structured interviews with 13 participants exploring current practice and learning needs, that were analyzed using an initial framework structured on interview questions, followed by inductive approach to identify additional themes. Awareness regarding evidence supporting exercise for knee OA and PFP was good (89–96%), and qualitative themes indicated physiotherapists emphasized exercise-therapy and education. Perceived value of passive treatments and surgery varied. Preference for face-to-face workshops to address learning needs, alongside describing time and cost barriers to access them, emerged from qualitative findings. Online learning formats were viewed as convenient, but not as effective as face-to-face learning. Knowledge and confidence related to interventions for knee OA and PFP of Australian and Canadian physiotherapist participants broadly aligns with guidelines. Knowledge translation strategies focused on face-to-face workshops, supported by online education may help to bridge evidence-to-practice gaps. [ABSTRACT FROM AUTHOR]

Objective: Paramedicine in Canada has experienced significant growth in recent years, which has resulted in a misalignment between existing guiding conceptualizations and how the profession is structured and enacted in practice. As a result, well-established boundaries, directions, and priorities may be poorly aligned with existing frameworks. The objective of this study was to explore emerging and future states of paramedicine in Canada such that guiding principles could be derived. We asked: How should paramedicine be conceptualized and enacted in Canada going forward, and, what might be the necessary enablers? Methods: This study involved in-depth one-on-one semi-structured interviews with Canadian paramedicine thought leaders. We used purposive and snowball sampling strategies to identify potential participants. Interview guide questions were used to stimulate discussion about the future of paramedicine in Canada and suggestions for implementation. We used inductive qualitative content analysis as our analytical approach, informed by a constructivist and interpretivist orientation. Results: Thirty-five key informants from across Canada participated in interviews. Ten themes were identified: (1) prioritizing patients and their communities; (2) providing health care along a health and social continuum; (3) practicing within an integrated health care framework, and partnering across sectors; (4) being socially responsive; (5) enacting professional autonomy; (6) integrating the health of professionals; (7) using quality-based frameworks; (8) enacting intelligent access to and distribution of services; (9) enacting a continuous learning environment; and, (10) being evidence-informed in practice and systems. Six enablers were also identified: shift professional culture and identity, enhance knowledge, promote shared understanding of paramedicine, integrate data environments, leverage advancing technology, advance policy, regulation and legislation. Conclusions: Our results provide a conceptual framework made up of guiding principles and enablers that provide a consolidated lens to advance the paramedicine profession in Canada (and elsewhere as appropriate) while ensuring contextual and regional needs and differences can be accounted for. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore how parents support the health behaviours of their child with a disability, and their motivations for registering their child in a health promotion program for children with physical and/or intellectual disabilities. Using a descriptive qualitative design, semi-structured face-to-face interviews were conducted with individual parents (n = 8) and one group (n = 3) to explore their experiences of health promotion for their child with a disability. Data were analyzed using thematic analysis to identify themes and patterns to develop an understanding of parental perspectives. Three themes were identified in the analysis of parents' experiences supporting their children in health behaviours and registering them in a disability health promotion program: (1) Parents struggle to meet all of their child's health promotion needs; (2) Parents recognize the social components of healthy behaviours; and (3) Health promotion opportunities tailored for children with disabilities are limited. These themes were not mutually exclusive and had overlapping factors that influenced parental experiences. Parents experience many challenges supporting the health behaviours of their children with disabilities. This study reinforces the need for accessible, developmentally appropriate, social health promotion programs for children with disabilities. Children with disabilities frequently demonstrate significantly higher sedentary behaviours, lower rates of physical activity and consumption of high-fat foods than their typically developing peers. Promoting healthy behaviours such as healthy eating and physical activity among children with disabilities and their families is therefore crucial to the child's physical and psychosocial wellbeing. Parents of children with disabilities have sufficient health literacy and knowledge but report a lack of appropriate opportunities and strategies to support their child in developing healthy behaviours. Parents need increased availability and accessibility of socially inclusive programs that promote healthy behaviours for children of all physical and cognitive abilities. [ABSTRACT FROM AUTHOR]

Lower limb exoskeletons are a recent intervention promoted to improve gait disorders. Available research has focused on clinical outcomes; however, little is known about therapists' experiences using the device in practice. We explored the implementation of an exoskeleton at a tertiary rehabilitation center. In this longitudinal qualitative study we conducted semi-structured interviews with 10 therapists. One group of therapists was formally trained using the device, whereas the other group only had clinical exposure to the device. The interviews were transcribed, coded, and analyzed for themes. Three main themes emerged: (1) A steep learning curve described challenges in learning to use the exoskeleton. (2) One step at a time illustrated the complex process of incorporating the exoskeleton in daily work. (3) Not a magic bullet revealed the tensions using this emergent technology in practice. The exoskeleton represents one of the most complicated and labor-intensive interventions provided by therapists. Implementation requires substantial resources, raising questions regarding its efficacy and cost-effectiveness relative to other approaches. Until more evidence becomes available around the use and effectiveness of this rapidly evolving technology, therapists must contend with a high degree of uncertainty. Using a lower limb exoskeleton may reduce physical demands on therapists in high-intensity rehabilitation programs that involve repetitive, effortful movements. However, a number of potential barriers to implementing the exoskeleton into practice need to be taken into consideration, including calibration time, intensive training required to become qualified to administer the intervention, the cost of the device, and comfort and safety of the device affecting user acceptance and uptake. Therapists also need to manage patient expectations related to outcomes related to use of exoskeletons. [ABSTRACT FROM AUTHOR]

Dropout is the term used by researchers and policy makers when referring to youth leaving or withdrawing from sport participation. To-date, the predominant use of quantitative approaches to researching dropout has limited our understanding of sport stakeholders' experiences and whether or not researchers' and stakeholders' perspectives of the dropout phenomenon are aligned. The purpose of this study therefore was to examine athletes', parents', and coaches' interpretations of the term dropout from youth sport through qualitative inquiry. Semi-structured interviews were conducted with 32 participants: 15 athletes (eight males and seven females, 11–19 years of age), 10 parents (five fathers and five mothers, 40–55 years of age), and 7 youth sport coaches (four males and three females, 28–58 years of age). Data were analyzed using inductive thematic analysis. The participants expressed a lack of familiarity with the use of the word dropout in sport and when asked to reflect on the potential theoretical implications of the term in the sport domain, the participants' perceptions were informed primarily by their preexisting understanding of dropout in the scholastic setting. Given their beliefs regarding the voluntary nature of sport and that decisions to leave sport may represent developmentally appropriate transitions for youth, the term dropout was often perceived to lack relevance to the participants. By exploring stakeholders' perspectives, these findings advance our understanding of withdrawal from youth sport. Recommendations for future research and practice are suggested. Lay summary: Youth athletes', parents', and coaches' views of the term dropout were examined. Participants associated dropout with failure: a lack of commitment, unrealized athletic potential, and inappropriate reasons for leaving. Participants suggested the term dropout lacked relevance in sport, citing the voluntary nature of sport and leaving as developmentally appropriate transitions. [ABSTRACT FROM AUTHOR]

Family members of patients admitted to the intensive care unit (ICU) experience multidimensional distress. Many clinicians lack an understanding of spiritual health practitioners' role and approaches to providing spiritual support. Through semi-structured interviews and focus groups with 10 spiritual health practitioners, we explored how spiritual health practitioners support families of patients in the ICU to better understand their scope of practice and role within an interdisciplinary critical care team. Spiritual health practitioners' work was described through clinical roles (family support, clinician support, bridging family members and clinicians), activities (companioning, counseling, facilitating difficult conversations, addressing individual needs), tensions (within and between roles and activities, navigating between hope and anticipated clinical trajectory, balancing supportive care and workload) and foundational principles (holistic perspective, resilience). A more comprehensive understanding of these roles and skills may enable clinicians to better integrate spiritual health practitioners into the fabric of care for patients, families, and clinicians themselves. [ABSTRACT FROM AUTHOR]

Purpose: To explore how people with end stage chronic obstructive pulmonary disease and their family members describe living in the face of impending death. Methods: A narrative inquiry was undertaken using a social constructionist perspective. Data were collected in 2017–18 in two in-depth interviews, lasting 90 to 120 minutes approximately 3–4 months apart, with a telephone follow-up 2–3 months later. Thematic analysis was conducted including analysis within and across participants. Results: Sixteen people with advanced chronic obstructive pulmonary disease and seven family members participated. For both people with the disease and family members, six key themes/storylines emerged including missing life, being vigilant, hope and realism, avoiding death talk, the scary dying process, and need to prepare. Conclusion: This study highlighted six key storylines about death and dying with advanced chronic obstructive pulmonary disease for people with the illness and their family members. The participants with the illness and their family members held similar perceptions about end of life. More supports are needed for people with advanced chronic obstructive pulmonary disease and their family members in living with their illness while ensuring that they experience a "good death." [ABSTRACT FROM AUTHOR]

One of the challenges for rehabilitation professionals is to discuss sexuality with their clients. The main objective of this study was to explore occupational therapists' perceptions of the factors that influence their practice regarding the domain of sexuality, as well as the prioritization of these factors and the exploration of their needs. Descriptive qualitative study who took place in Montreal, Canada. Two focus groups were realized with seven occupational therapists working in outpatient setting in two different rehabilitation centers for physical disabilities. The focus group guide was based on the Theoretical Domains Framework (TDF). The verbatims were coded using QDA-Miner software and analyzed according to the principles of the Framework approach. The majority of participants were women (n = 6/7). Three main themes to answer the main objective emerged: (1) Occupational therapist's intrinsic factors such as professional identity and knowledge/skills; (2) Contextual and process factors of practice, including assessment/analysis and human resources; (3) Client factors such as identity factors and capabilities. Several influencing factors that have a significant impact on practice have been prioritized, for instance, the perception of the skill level of occupational therapists, interdisciplinary collaboration, culture/language and openness of the client to the subject of sexuality. The needs related to the acquisition of knowledge/know-how, human resources and continuing education were raised by clinicians. There is a need in developing training tools to support clinical practice and to overcome the many barriers encountered by occupational therapists regarding the domain of sexuality. Addressing sexuality domain with their clients remains a challenge for occupational therapists working in outpatient physical disability rehabilitation. Several factors influence the practice of occupational therapists in the domain of sexuality, including occupational therapist's intrinsic factors, their practice process, contextual factors and client-related factors. Improved interdisciplinary practice in sexuality is needed to ensure that sexuality is addressed and that there are referrals to the proper health professionals according to clients' needs. The availability of sexology resources is an important factor for occupational therapists addressing sexuality. [ABSTRACT FROM AUTHOR]