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Background. Persons experiencing or at risk of homelessness have occupational needs that are seldom addressed in the Canadian system of care. The lack of documented evidence on occupational therapy practices in this field hinders the development of the profession. Purpose. This article identifies current and potential practices that aim to enable or support the occupations of persons experiencing or at risk of homelessness. Method. A scoping review was conducted, including evidence from both occupational therapy and non–occupational therapy sources. Findings. One hundred and seventy-eight papers were selected in the areas of occupational performance skills training, enrichment of occupational repertoire, employment/education, physical rehabilitation services, child/family services, community building, occupational transition from homeless to housed, literacy, and disaster relief. Implications. Occupational therapists can build environments and create opportunities that facilitate occupational engagement of individuals experiencing homelessness. Gaps in knowledge include the evaluation of occupational therapy practices, the Canadian context of family homelessness, and the cultural safety of occupational therapy interventions. [ABSTRACT FROM AUTHOR]

Research identifies unique challenges for younger women diagnosed with breast cancer at or before 45 years of age. This paper explores the experiences of younger women from diverse cultural backgrounds with breast cancer to see if there are differing healthcare provision needs across cultures. Sandelowski and Barroso's framework for undertaking a meta-synthesis is used in this paper. Initial searches in academic databases returned 42 papers of interest. Re-reading the papers in the context of the research question identified 12 studies which met the inclusion criteria. Five key themes were identified in these 12 studies. The overarching finding is that, irrespective of cultural background, the confrontation with breast cancer transforms the younger woman's life. It seems that healthcare provision needs do not differ substantially across cultures. Health professionals should address the unique psychosocial effects of cancer in the context of the lifestage of the woman. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

Canada is home to a growing immigrant population. However, immigrant mental health declines over time following arrival in Canada. Canada's Mental Health Strategy emphasizes the importance of research that gathers information from multiple sources of knowledge to identify the mental health challenges faced by diverse immigrant populations. Mixed methods research (MMR) is well suited for this task. However, a dearth of research exists on the application of MMR to the study of immigrant mental health. A systematic review of the published MMR literature in Canadian immigrant mental health was carried out. Overall, existing MMR studies failed to incorporate correct mixed methods terminology and fully integrate the quantitative and qualitative components of the research. A checklist of important elements to include in MMR studies is offered. [ABSTRACT FROM AUTHOR]

Objectives: To identify what factors affect women's' decisions to delay childbearing, and to explore women's' experiences and their perceptions of associated risks. Design: Systematic procedures were used for search strategy, study selection, data extraction and analysis. Findings were synthesised using an approach developed from meta-ethnography. Data sources: We included qualitative papers, not confined to geographical area (1980–2009). Databases included CINAHL, MEDLINE, EMBASE, PsycInfo, ASSIA, MIDIRS, British Nursing Index and the National Research Register. We selected qualitative empirical studies exploring the views and experiences of women of advanced maternal age who were childless or primigravidae with a singleton pregnancy or primiparous. Review methods: Twelve papers fulfilled the selection criteria and were included for synthesis. Results: Women appear to face an issue of ‘informed and uninformed decision making’; those who believe they are informed but may not be, those who are not informed and find out they are at risk once pregnant, and those who are well informed but choose to delay pregnancy anyway. Maternity services could provide information to enable informed choice regarding timing of childbearing. Conclusions: Health professionals need to be mindful of the fact that women delay childbearing for various reasons. A strategy of pre-conception education may be beneficial in informing childbearing decisions. Obstetricians and midwives should be sensitive to the fact that women may not be aware of all the risks associated with delayed childbearing. [Copyright &y& Elsevier]

Aims and Objectives: To illustrate the scope of different types of transitional, community‐based health interventions for formerly incarcerated women, trans and nonbinary people, the eligibility criteria for these interventions, and associated health outcomes. Background: Meeting the health needs of formerly incarcerated people in community, rather than through the criminal justice system, may prevent further experiences of criminalization. Research is needed to understand what community‐based health interventions have been implemented internationally to inform the design of an intervention in Canada. Design: Scoping review using the Joanna Briggs Institute scoping review methodology. Methods: In consultation with a medical research librarian, key databases and journals were searched for English language articles, from any country, with no specified date range. Three authors independently screened titles and abstracts to identify articles for full‐text review. The study adheres to PRISMA‐EQUATOR guidelines. Results: Thirty‐six studies met the present criteria and were reviewed in full text. Method, setting, participants, sample, relevant outcomes and relevant findings were extracted from each study for synthesis. Included studies had varied methods and were published from 1999 to 2020. Thirty‐one studies were based in the United States, one in Puerto Rico and two each in Canada and the United Kingdom. The most common health issue focus was human immunodeficiency virus and/or hepatitis c virus. The most common outcome was uptake of offered services, such as a transitional clinic. Conclusions: Gaps in the research pertain to a lack of attention to clinical outcomes and patient experience, and a lack of consideration of sexual and reproductive health concerns. Women were the minority population in all studies that included both men and women; transgender participants were mentioned in only four of thirty‐six studies. The specific needs of women, trans and nonbinary people must be taken into consideration. Relevance to clinical practice: Nurses must be conscious of the elevated health risks associated with exposure to correctional institutions and the risks associated with the period of transition. Patient or Public Contribution: A member of the research team brings lived experience expertise with respect to the criminal justice system. [ABSTRACT FROM AUTHOR]

In many countries across the world, older people are one of the groups most vulnerable to loneliness. Community‐based responses are well placed to support and enhance pre‐existing coping strategies in older people. However, the evidence base of these responses remain scattered and obscured, particularly in relation to their design and reasons behind their success. In this systematic review, we focus on qualitative studies on community‐based responses to loneliness among older people to learn how these responses work in practice with in‐depth details. At the end of a systematic searching and screening process, 17 studies conducted in five countries (Australia, Canada, New Zealand, Spain and the UK) published in English were selected and reviewed initially in October 2020 and then updated at the end of August 2021. Three themes were identified as being most valuable to addressing loneliness in a specific community, namely, autonomy, new social connections, and belonging. These interventions were also employed according to three primary considerations: what the community lacked, how that community experienced loneliness, or a combination of both. Several implications for policymakers and future research emerged, urging future interventions to take a more contextual approach that encompasses community‐level considerations before establishing a user‐led and tailored setting that facilitates social engagement. [ABSTRACT FROM AUTHOR]

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples' preferences, needs, opportunities and barriers to palliative care. Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly's hierarchy of evidence-for-practice in qualitative research. Results: Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples' experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. Conclusions: The results provide a comprehensive overview of identified effective practices with regards to palliative care delivered to Indigenous populations to guide future program developments in this field. Further research is required to explore the palliative care needs and experiences of Indigenous people living in urban areas. [ABSTRACT FROM AUTHOR]

brereton l., gardiner c., gott m., ingleton c., barnes s. & carroll c. (2011) The hospital environment for end of life care of older adults and their families: an integrative review. Journal of Advanced Nursing 68(5), 981-993. Abstract Aim. This article is a report of an integrative review to identify key elements of the physical hospital environment for end of life care of older adults and their families as reported by patients, relatives, staff and policy makers. Background. Globally ageing populations and increases in long-term illness mean that more people will need palliative care in the future. Despite policy initiatives to increase end of life care in the community, many older adults prefer, and will require, end of life care in hospital. Providing an appropriate physical environment for older adults requiring end of life care is important given concerns about hospital environments for this group. Data sources. Thirteen databases from 1966 to 2010 were searched including ASSIA, BNI, Cochrane Library, CINAHL, EMBASE, MEDLINE, PsycINFO, Social Science Citation Index, the Science Citation Index, HMIC and the National Research Register. Reference and citation tracking was performed on included publications. Review methods. An integrative review was conducted. Two reviewers independently screened titles and abstracts for inclusion and completed data extraction. Study quality is not reported as this poses methodological difficulties in integrative reviews. Data synthesis involved thematic analysis informed by the findings of included literature. Results. Ten articles were included. Four themes were identified: privacy as needed; proximity (physically and emotionally) to loved ones, home and nature; satisfaction with the physical environment; and deficiencies in physical environment. Conclusion. Little evidence exists about physical hospital environments for end of life care of older adults and their families. More research is required in this field. [ABSTRACT FROM AUTHOR]

The goal of this literature review is to provide a critical overview of existing research on the health of immigrant youth within the last decade. Although the review focuses primarily on Canada, the findings have implications for public health planning, policy, and settlement/immigration services in other immigrant-receiving countries. The main objectives are: (i) to locate relevant literature written in the past 10 years (January 1998–January 2008); (ii) to undertake a critical review of retrieved studies; (iii) to highlight gaps in the current state of our knowledge and make recommendations for future research directions. The review focuses on the influence of migration experience on health of youth. [ABSTRACT FROM AUTHOR]

Aim and objectives. To identify the theories and concepts related to building age-friendly rural communities. Background. Global population is rapidly ageing. Creating environments that support active ageing was a catalyst for the World Health Organization to develop Global Age-Friendly Cities guidelines. Although the age-friendly movement has captured the attention of some countries, little is known about the participation of older people in rural settings. Method. An integrative review approach was employed to summarise the research literature on this topic. Using a systematic search strategy, databases including Discover (EBSCO's electronic database system), Web of Science, Scopus, PubMed, CINAHL, PsycINFO, Medline and Google Scholar were searched. Primary, peer-reviewed studies were included if published during 2007-2014 in the English language. Results. Nine studies were eligible for inclusion. The studies were set predominantly in Canada, with the exception of one from Ireland. The findings were summarised and clustered into main topics which included: theoretical perspectives; geographic and demographic characteristics; collaboration and partnerships; sus-tainability and capacity; and finally, future research agendas. Conclusions. Rural communities are changing rapidly and are becoming increasingly diverse environments. Community characteristics can help or hinder age-friendliness. Importantly, the fundamental starting point for age-friendly initiatives is establishing older peoples' perceptions of their own communities. Relevance to clinical practice. It is important for nurses, working in primary health care settings, to understand the needs of older people in the communities in which they practice. This includes the community characteristics that can be enablers and barriers to older people being able to remain and age within their own communities. [ABSTRACT FROM AUTHOR]

Aims and objectives. To determine, from a systematic literature review, the experience of living with heart failure and to propose some practice guidelines and research questions. Background. Chronic heart failure has been one of the fastest growing illnesses in recent decades, with almost 23 million people affected worldwide. This complex syndrome has multiple causes and appears when underlying heart disease is advanced. Currently, heart failure has no cure and leads to a significant deterioration in patients' quality of life. Design. Qualitative meta-synthesis. Methods. A qualitative meta-synthesis was conducted to extract and analyse qualitative research from the Cochrane, PubMed, CINAHL, PsycINFO, Web of Science and Cuiden databases. Snowball sampling and a manual search were performed to identify other relevant studies. Results. Twenty-five qualitative studies were selected. The findings indicate that there are three main themes that describe the phenomenon. The first theme refers to the experiences related to the beginning of the process. The second theme is connected with the effects on the person: physical, emotional, social and spiritual changes. The third theme is linked with how to live with heart failure despite the illness, including the adjustment and coping process and how external resources can help them to manage. Conclusions. Heart failure has a major impact on the entire person, but some areas have not been addressed. By creating new tools to understand and evaluate the impact of this illness and interventions that prevent or improve some situations, we can promote the well-being and the quality of life of this population. Relevance to clinical practice. Nurses must have a personal knowledge of the experiences and needs of the patients. To do this, nurses should create care environments that promote an exchange of experiences and knowledge between the nurse and the patient and family. [ABSTRACT FROM AUTHOR]

The creative arts can be used to support stakeholders of mental health services to communicate and share their lived experience. Digital storytelling is one method that has been used to capture people's lived experience. In this scoping review, we were interested in mapping how digital storytelling has been used in mental health, and to identify gaps in the literature. Nine databases were searched to identify peer reviewed literature published between January 2000 and August 2015; 15 articles were included in the review. The articles were categorized across four broad areas: educational interventions, learning skills, learning about other people's lived experience, and learning about personal lived experience. We identify that while digital storytelling has potential as a participatory process to promote mutual understanding of and empathy towards lived experiences in mental health, there is a dearth of research in this area. More research is needed on the use of digital storytelling in mental health to determine its effectiveness in progressing a recovery orientation in service provision that is built on solidarity and a social justice agenda. [ABSTRACT FROM AUTHOR]

Canadian population-based surveys report comparable access to health care services between immigrant and non-immigrant populations, yet other research reports immigrant-specific access barriers. A scoping review was conducted to explore research regarding Canadian immigrants' unique experiences in accessing health care, and was guided by the research question: 'What is currently known about the barriers that adult immigrants face when accessing Canadian health care services?' The findings of this study suggest that there are unmet health care access needs specific to immigrants to Canada. In reviewing research of immigrants' health care experiences, the most common access barriers were found to be language barriers, barriers to information, and cultural differences. These findings, in addition to low cultural competency reported by interviewed health care workers in the reviewed articles, indicate inequities in access to Canadian health care services for immigrant populations. Suggestions for future research and programming are discussed. [ABSTRACT FROM AUTHOR]

Mental health issues affect 20–25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services in SBHCs. Databases were searched extensively for research studies published between January 1990 and March 2014. Data analysis was based on the method proposed by the Centre for Reviews and Dissemination. Twenty-three studies were selected for review. Each study was explored for accessibility and content of mental health services in SBHCs. SBHCs provide access and eliminate barriers to mental health services. Students who exhibited high-risk behaviors were more likely to have sought services at the SBHC. However, there is a lack of high-quality research evaluating mental health services in the SBHCs and their effect on children and adolescents. [ABSTRACT FROM AUTHOR]

The article discusses a study on the perception of nursing students/ educators on the contribution of ethics education to ethical competence of nursing students. It addresses questions including how they look at general contribution of ethics education, contribution of ethics education to ethical competence and features of ethics education needed to promote ethical competence. It suggests that ethics education adds to the ethical awareness and ethical reasoning competencies of nursing students.

The relationship between foster children and carers' own offspring has been investigated in many studies within foster care. However, while general patterns and outcomes have been established, the explanations underlying this relationship are more likely to be found in the common themes of smaller studies based on psychological theories published in academic and professional journals. This review by Hayley Thompson and Susan McPherson examines 14 published articles describing 12 different research studies, all exploring the experience of living with foster siblings, as described by the birth children of foster carers. These 12 studies include primarily qualitative evidence, although four also use forced choice and open response questionnaires. Taken together, the studies reviewed reflect the experiences of 1,102 children, aged between three and 32 years. They discuss the positive gains of fostering, the experience of loss, the conflict experienced, the transitions made and ways in which children manage the foster sibling relationship. These findings are discussed in relation to psychological theories, and proposals for future research and clinical practice are outlined. Conclusions are also drawn about the contribution of small-scale studies published in journals in disseminating research findings about fostered children. [ABSTRACT FROM AUTHOR]