Andrew Estefan - Academia.edu (original) (raw)

Papers by Andrew Estefan

International and Cultural Psychology, 2018

In this chapter, we explore the story of Stephen, a composite female-to-male transgender client, ... more In this chapter, we explore the story of Stephen, a composite female-to-male transgender client, derived from the practice experiences of the first author. We engage with Stephen’s story in order to explore key aspects of culture-infused counselling. As part of Stephen’s story, we explore the issue of self-harm to illustrate ways counsellors can engage in life-making and self-composition alongside transgender clients. Culture-infused counselling (CIC; Collins & Arthur, 2010a, 2010b) is woven throughout this chapter to illustrate how it brings counsellor and client together in a therapeutic relationship characterized by a commitment to each know the other and to engage in helpful therapeutic work. In reflecting on the application of the revised CIC framework (see Chap. 2), we emphasize the importance of sustaining sensitivity to the role culture plays in shaping client and therapist identities. We also explore how cultural awareness of self informs the therapeutic relationship. Used concurrently, these approaches help sustain a practice in which transgender clients and counsellors can work together in meaningful and forward-looking ways.

Empowerment Strategies for Nurses, 2019

2018 University of Calgary Conference on Postsecondary Learning and Teaching, Apr 17, 2018

Empowerment Strategies for Nurses, 2019

Journal of Transport & Health, 2017

Background: This presentation is a result of a successful PhD dissertation in Counselling Psychol... more Background: This presentation is a result of a successful PhD dissertation in Counselling Psychology at the University of Calgary. It was a qualitative study exploring the experiences of therapists who use Walk and Talk Therapy in their practices. In this presentation, I will highlight the practical ways in which professionals can use what I learned in this study right here on the streets of Calgary. Description of Program: There is a traditional notion that therapeutic conversations are best suited for offices with four walls. Therapists are reconsidering this practice by engaging in walks with clients in order to reconnect with the world around them, engage in exercise, and reflect on life problems in natural and urban spaces. Calgary, with its vast park spaces, walking paths, and walkable downtown is the perfect city for this practice to grow. The research in Ecotherapy and Walk and Talk Therapy is growing. This means that not only can we look at the practical aspects of Walk and Talk in our city, we can also come together to generate further research in this innovative and growing area of psychology. Outcomes: Within this innovative practice there are key concepts to consider including ethical practice and confidentiality, how walking may enhance reflective practice in therapy, the promotion of self-care practices for both the client and the therapist, and how to increase a sense of connectedness to the outside world through Walk and Talk Therapy. Implications: In this presentation, I will highlight the experiences of therapists who participate in this practice, present the benefits of the practice, and provide a series of reflective questions for individuals who may be interested in participating in Walk and Talk Therapy in Calgary. These questions include practical considerations (ex. safety, fitness levels, weather, walking routes), professional development, therapeutic effectiveness, and general motivation to invite creativity and innovation into one's therapeutic practice. While this study was focused on therapy, the idea of walking with clients could easily be expanded to include many other professions.

Tom Hickerson, Vice Provost, Libraries and Cultural Resources, University of Calgary Jarett Henry... more Tom Hickerson, Vice Provost, Libraries and Cultural Resources, University of Calgary Jarett Henry, University of Calgary Students’ Union Andrew Estefan, Faculty of Nursing, University of Calgary Marjan Eggermont, Schulich School of Engineering Erin McKiernan, National Institute of Public Health, Mexico Introductory remarks by Andrew Waller, Libraries and Cultural Resources, University of Calgary

Nurse Education in Practice, 2021

AIM Horizontal violence (HV) is a familiar term used in nursing. Certain populations of nurses ar... more AIM Horizontal violence (HV) is a familiar term used in nursing. Certain populations of nurses are more susceptible to HV than others. Graduate nurses (nurses within their first 12 months of practice) are widely considered a vulnerable population in the profession and thus more at risk for HV. The purpose of this qualitative study was to explore how HV affects graduate nurses (GNs). DESIGN Inductive thematic analysis was used in the design of this study. METHODS Participants included eight Canadian GNs or Registered Nurses (RNs), all of whom had experience with HV in their first 12 months of practice. Data collection was done via one-on-one interviews. RESULTS Two main themes were revealed from the data collected - Toxic Nursing Culture and Fear. Several subthemes were also identified - cycle of violence, nurses eating their young, shame, drowning, isolation and vulnerability. The findings indicate that HV is prevalent in the first year of practice and is destructive to the mental health of the individual nurse. Horizontal violence poses a serious challenge for GNs entering nursing and is often touted as the reason new nurses leave the profession altogether. CONCLUSION This study highlighted the personal and professional challenges that are heightened for a GN when they experience HV in their first year of practice. These experiences emphasize the impact that HV can have on the mental health of nurses and their ability to deliver safe patient care.

Research and Theory for Nursing Practice, 2019

Background and PurposeHarm reduction is a concept that is increasingly applied in health and soci... more Background and PurposeHarm reduction is a concept that is increasingly applied in health and social care, as well as law and policy development around the world. Despite being used in a variety of contexts for decades, there is no universal understanding of harm reduction, and this may interfere with its implementation in various settings. Using Rodgers' (1989) evolutionary approach to concept analysis, this article defines the key attributes of harm reduction, along with surrogate terms, relevant uses, antecedents, consequences, related concepts, a model case, and implications for practice.MethodsFollowing Rodgers' (1989) method, a literature sample from a variety of disciplines was selected using keywords. The review included 25 key publications of international origin, as well as several web-based resources, with a focus on illegal psychoactive drug use and healthcare outcomes.ResultsSeven key attributes of harm reduction were identified: a focus on harms, the participati...

Journal of Pediatric Oncology Nursing, 2017

The purpose of this philosophical hermeneutic study was to determine if, and understand how, digi... more The purpose of this philosophical hermeneutic study was to determine if, and understand how, digital stories might be effective therapeutic tools to use with children and adolescents/young adults (AYA) with cancer, thus helping mitigate suffering. Sixteen participants made digital stories with the help of a research assistant trained in digital storytelling and were interviewed following the completion of their stories. Findings from this research revealed that digital stories were a way to have others understand their experiences of cancer, allowed for further healing from their sometimes traumatic experiences, had unexpected therapeutic effects, and were a way to reconcile past experiences with current life. Digital stories, we conclude, show great promise with the pediatric and AYA oncology community and we believe are a way in which the psychosocial effects of cancer treatment may be addressed. Recommendations for incorporating digital stories into clinical practice and follow-u...

Journal of Family Nursing, 2016

This article is the first of a three-part report of a research study that used hermeneutic inquir... more This article is the first of a three-part report of a research study that used hermeneutic inquiry to examine the effects of childhood cancer on the relationship between the parents of the child. In Part 1, we identity the topic of investigation and the relevant literature; describe the research question, method, and design; and begin our interpretations of the data with a focus on the couples who remained together and those who experienced relationship demise. In this analysis, we discovered that issues of difference and trading played a strong role in how the couples fared in their relationships. In Part 2 of this series, we focus on further interpretations, and in Part 3, we discuss the implications of the study for other parents and for health care professionals.

Journal of the Association of Nurses in AIDS Care, 2016

With a call to increase the accessibility of HIV testing, point-of-care testing for HIV is being ... more With a call to increase the accessibility of HIV testing, point-of-care testing for HIV is being readily adopted, but little attention has been paid to the experiences of people being tested at HIV point-of-care sites. Some testing environments, such as bathhouses, promote testing for HIV in higher-risk groups. In this narrative inquiry study we explored the experiences of people testing positive for HIV through point-of-care while at a bathhouse. Three narrative threads for reconsidering the practice were identified: (a) seeing complexities, understanding testing decisions in relation to time, place, and social context; (b) recognizing the impact and significance of secret and silent stories; and (c) tentative and tension-filled connections to care. It is important to understand testing experiences across time, place, and in diverse social contexts. These experiences are embedded within the larger life histories of people and raise questions about adequate support, follow-up, and counseling.

Annals of Internal Medicine, 2013

The author has disclosed that he does not have any potential conflicts of interest.

The purpose of this integrative research paper was to explore and critique the state of knowledge... more The purpose of this integrative research paper was to explore and critique the state of knowledge derived from qualitative and quantitative research conducted in the area of Post-Traumatic Stress Disorder (PTSD) and refugees and immigrants from South Sudan. In the paper, I discuss the extent of knowledge about this population and associated PTSD. Crucial interventions that appeared in this literature review were evaluated and analyzed. Ethical practice and considerations when working with South Sudanese refugees and immigrants are discussed. The paper is concluded with some recommendations for individual and group practice, further research, and policy development.

Journeys in Narrative Inquiry

Decision-making is a key component of registered nurse practice. The decisions registered nurses ... more Decision-making is a key component of registered nurse practice. The decisions registered nurses make in practice have important consequences for healthcare provision and patient outcomes. In critical care, nurses make decisions in complex circumstances, including crisis events in which nurses and others must respond quickly and effectively. The ways that nurses in critical care environments make decisions during crises has not been well studied. Within the nursing and other literature there are numerous theories, conceptualizations, and expert opinions about what constitutes decision-making but few of these describe what is happening when nurses make decisions in their practice contexts. This study was a classical grounded theory study to explain how critical care nurses make decision in crises. Data were collected from ten participants and analyzed using constant comparative analysis. The theory Enacting Strategic Memory accounts for the data provided by participants and explains ...

Turk Talk is a real-time chat session embedded in a virtual patient simulation. Turk Talk require... more Turk Talk is a real-time chat session embedded in a virtual patient simulation. Turk Talk requires students to use therapeutic communication skills to formulate their responses to virtual patients. These virtual patient scenarios are a hybrid approach to facilitate undergraduate nursing students' development of therapeutic communication. This thesis reports a thematic analysis that is part of a broader evaluation of Turk Talk. The study is grounded in key tenets of critical realism, social constructivism, socio-materialism, and student-centered learning theory. The purpose of this study was to explore students' experiences of learning therapeutic communication using Turk Talk in a fourth-year undergraduate mental health and addictions nursing course. Three themes emerged: (a) Communication as Performance; (b) Communication as Discovery; and, (c) Communication as Cultivating Practice. Turk Talk requires students to use therapeutic communication skills to formulate their respo...

This is a narrative study of daily lives for families who have a member with a disability (famili... more This is a narrative study of daily lives for families who have a member with a disability (families with disability). Families with disability are often studied in a way that centralizes disability rather than personhood. The medical model and social models of disability work to create a framework of how disability might be viewed. However, these models are problematic because they have a tendency to cover over the smaller, more subjective stories of disability. Stories told by families with disability are important to tell, hear, and understand because they provide new and alternative ways of looking at life with disability. In this study, I interviewed families (being any group of people that consider themselves to be family) with disability. I conducted interviews with two or more members of five families who have a member with disability. Narrative analysis of data resulted in the writing of three stories that tell of daily life for families with disability. The stories are then...

This study addresses a significant clinical and social issue: self-injury among gay men. Self-inj... more This study addresses a significant clinical and social issue: self-injury among gay men. Self-injury can be understood as any act undertaken by the self to cause physical damage to the body without the conscious intent to die. The existing self-injury literature tends to focus on self-injury as a problem for women. That is to say, because more women than men self-injure, research focuses more strongly on their motivations and treatment needs. The literature that explores self-injury as it relates to gay men is not well developed and focuses strongly on suicidality and the risks associated with various self-injurious behaviours. This has produced useful information for some areas of practice such as risk management and public health suicide prevention strategies. What this literature has not done is explore the contexts and meanings of self-injury for this particular group. This study is a narrative inquiry, which explores gay men's self-injury through their experiences in contex...

International and Cultural Psychology, 2018

In this chapter, we explore the story of Stephen, a composite female-to-male transgender client, ... more In this chapter, we explore the story of Stephen, a composite female-to-male transgender client, derived from the practice experiences of the first author. We engage with Stephen’s story in order to explore key aspects of culture-infused counselling. As part of Stephen’s story, we explore the issue of self-harm to illustrate ways counsellors can engage in life-making and self-composition alongside transgender clients. Culture-infused counselling (CIC; Collins & Arthur, 2010a, 2010b) is woven throughout this chapter to illustrate how it brings counsellor and client together in a therapeutic relationship characterized by a commitment to each know the other and to engage in helpful therapeutic work. In reflecting on the application of the revised CIC framework (see Chap. 2), we emphasize the importance of sustaining sensitivity to the role culture plays in shaping client and therapist identities. We also explore how cultural awareness of self informs the therapeutic relationship. Used concurrently, these approaches help sustain a practice in which transgender clients and counsellors can work together in meaningful and forward-looking ways.

Empowerment Strategies for Nurses, 2019

2018 University of Calgary Conference on Postsecondary Learning and Teaching, Apr 17, 2018

Empowerment Strategies for Nurses, 2019

Journal of Transport & Health, 2017

Background: This presentation is a result of a successful PhD dissertation in Counselling Psychol... more Background: This presentation is a result of a successful PhD dissertation in Counselling Psychology at the University of Calgary. It was a qualitative study exploring the experiences of therapists who use Walk and Talk Therapy in their practices. In this presentation, I will highlight the practical ways in which professionals can use what I learned in this study right here on the streets of Calgary. Description of Program: There is a traditional notion that therapeutic conversations are best suited for offices with four walls. Therapists are reconsidering this practice by engaging in walks with clients in order to reconnect with the world around them, engage in exercise, and reflect on life problems in natural and urban spaces. Calgary, with its vast park spaces, walking paths, and walkable downtown is the perfect city for this practice to grow. The research in Ecotherapy and Walk and Talk Therapy is growing. This means that not only can we look at the practical aspects of Walk and Talk in our city, we can also come together to generate further research in this innovative and growing area of psychology. Outcomes: Within this innovative practice there are key concepts to consider including ethical practice and confidentiality, how walking may enhance reflective practice in therapy, the promotion of self-care practices for both the client and the therapist, and how to increase a sense of connectedness to the outside world through Walk and Talk Therapy. Implications: In this presentation, I will highlight the experiences of therapists who participate in this practice, present the benefits of the practice, and provide a series of reflective questions for individuals who may be interested in participating in Walk and Talk Therapy in Calgary. These questions include practical considerations (ex. safety, fitness levels, weather, walking routes), professional development, therapeutic effectiveness, and general motivation to invite creativity and innovation into one's therapeutic practice. While this study was focused on therapy, the idea of walking with clients could easily be expanded to include many other professions.

Tom Hickerson, Vice Provost, Libraries and Cultural Resources, University of Calgary Jarett Henry... more Tom Hickerson, Vice Provost, Libraries and Cultural Resources, University of Calgary Jarett Henry, University of Calgary Students’ Union Andrew Estefan, Faculty of Nursing, University of Calgary Marjan Eggermont, Schulich School of Engineering Erin McKiernan, National Institute of Public Health, Mexico Introductory remarks by Andrew Waller, Libraries and Cultural Resources, University of Calgary

Nurse Education in Practice, 2021

AIM Horizontal violence (HV) is a familiar term used in nursing. Certain populations of nurses ar... more AIM Horizontal violence (HV) is a familiar term used in nursing. Certain populations of nurses are more susceptible to HV than others. Graduate nurses (nurses within their first 12 months of practice) are widely considered a vulnerable population in the profession and thus more at risk for HV. The purpose of this qualitative study was to explore how HV affects graduate nurses (GNs). DESIGN Inductive thematic analysis was used in the design of this study. METHODS Participants included eight Canadian GNs or Registered Nurses (RNs), all of whom had experience with HV in their first 12 months of practice. Data collection was done via one-on-one interviews. RESULTS Two main themes were revealed from the data collected - Toxic Nursing Culture and Fear. Several subthemes were also identified - cycle of violence, nurses eating their young, shame, drowning, isolation and vulnerability. The findings indicate that HV is prevalent in the first year of practice and is destructive to the mental health of the individual nurse. Horizontal violence poses a serious challenge for GNs entering nursing and is often touted as the reason new nurses leave the profession altogether. CONCLUSION This study highlighted the personal and professional challenges that are heightened for a GN when they experience HV in their first year of practice. These experiences emphasize the impact that HV can have on the mental health of nurses and their ability to deliver safe patient care.

Research and Theory for Nursing Practice, 2019

Background and PurposeHarm reduction is a concept that is increasingly applied in health and soci... more Background and PurposeHarm reduction is a concept that is increasingly applied in health and social care, as well as law and policy development around the world. Despite being used in a variety of contexts for decades, there is no universal understanding of harm reduction, and this may interfere with its implementation in various settings. Using Rodgers' (1989) evolutionary approach to concept analysis, this article defines the key attributes of harm reduction, along with surrogate terms, relevant uses, antecedents, consequences, related concepts, a model case, and implications for practice.MethodsFollowing Rodgers' (1989) method, a literature sample from a variety of disciplines was selected using keywords. The review included 25 key publications of international origin, as well as several web-based resources, with a focus on illegal psychoactive drug use and healthcare outcomes.ResultsSeven key attributes of harm reduction were identified: a focus on harms, the participati...

Journal of Pediatric Oncology Nursing, 2017

The purpose of this philosophical hermeneutic study was to determine if, and understand how, digi... more The purpose of this philosophical hermeneutic study was to determine if, and understand how, digital stories might be effective therapeutic tools to use with children and adolescents/young adults (AYA) with cancer, thus helping mitigate suffering. Sixteen participants made digital stories with the help of a research assistant trained in digital storytelling and were interviewed following the completion of their stories. Findings from this research revealed that digital stories were a way to have others understand their experiences of cancer, allowed for further healing from their sometimes traumatic experiences, had unexpected therapeutic effects, and were a way to reconcile past experiences with current life. Digital stories, we conclude, show great promise with the pediatric and AYA oncology community and we believe are a way in which the psychosocial effects of cancer treatment may be addressed. Recommendations for incorporating digital stories into clinical practice and follow-u...

Journal of Family Nursing, 2016

This article is the first of a three-part report of a research study that used hermeneutic inquir... more This article is the first of a three-part report of a research study that used hermeneutic inquiry to examine the effects of childhood cancer on the relationship between the parents of the child. In Part 1, we identity the topic of investigation and the relevant literature; describe the research question, method, and design; and begin our interpretations of the data with a focus on the couples who remained together and those who experienced relationship demise. In this analysis, we discovered that issues of difference and trading played a strong role in how the couples fared in their relationships. In Part 2 of this series, we focus on further interpretations, and in Part 3, we discuss the implications of the study for other parents and for health care professionals.

Journal of the Association of Nurses in AIDS Care, 2016

With a call to increase the accessibility of HIV testing, point-of-care testing for HIV is being ... more With a call to increase the accessibility of HIV testing, point-of-care testing for HIV is being readily adopted, but little attention has been paid to the experiences of people being tested at HIV point-of-care sites. Some testing environments, such as bathhouses, promote testing for HIV in higher-risk groups. In this narrative inquiry study we explored the experiences of people testing positive for HIV through point-of-care while at a bathhouse. Three narrative threads for reconsidering the practice were identified: (a) seeing complexities, understanding testing decisions in relation to time, place, and social context; (b) recognizing the impact and significance of secret and silent stories; and (c) tentative and tension-filled connections to care. It is important to understand testing experiences across time, place, and in diverse social contexts. These experiences are embedded within the larger life histories of people and raise questions about adequate support, follow-up, and counseling.

Annals of Internal Medicine, 2013

The author has disclosed that he does not have any potential conflicts of interest.

The purpose of this integrative research paper was to explore and critique the state of knowledge... more The purpose of this integrative research paper was to explore and critique the state of knowledge derived from qualitative and quantitative research conducted in the area of Post-Traumatic Stress Disorder (PTSD) and refugees and immigrants from South Sudan. In the paper, I discuss the extent of knowledge about this population and associated PTSD. Crucial interventions that appeared in this literature review were evaluated and analyzed. Ethical practice and considerations when working with South Sudanese refugees and immigrants are discussed. The paper is concluded with some recommendations for individual and group practice, further research, and policy development.

Journeys in Narrative Inquiry

Decision-making is a key component of registered nurse practice. The decisions registered nurses ... more Decision-making is a key component of registered nurse practice. The decisions registered nurses make in practice have important consequences for healthcare provision and patient outcomes. In critical care, nurses make decisions in complex circumstances, including crisis events in which nurses and others must respond quickly and effectively. The ways that nurses in critical care environments make decisions during crises has not been well studied. Within the nursing and other literature there are numerous theories, conceptualizations, and expert opinions about what constitutes decision-making but few of these describe what is happening when nurses make decisions in their practice contexts. This study was a classical grounded theory study to explain how critical care nurses make decision in crises. Data were collected from ten participants and analyzed using constant comparative analysis. The theory Enacting Strategic Memory accounts for the data provided by participants and explains ...

Turk Talk is a real-time chat session embedded in a virtual patient simulation. Turk Talk require... more Turk Talk is a real-time chat session embedded in a virtual patient simulation. Turk Talk requires students to use therapeutic communication skills to formulate their responses to virtual patients. These virtual patient scenarios are a hybrid approach to facilitate undergraduate nursing students' development of therapeutic communication. This thesis reports a thematic analysis that is part of a broader evaluation of Turk Talk. The study is grounded in key tenets of critical realism, social constructivism, socio-materialism, and student-centered learning theory. The purpose of this study was to explore students' experiences of learning therapeutic communication using Turk Talk in a fourth-year undergraduate mental health and addictions nursing course. Three themes emerged: (a) Communication as Performance; (b) Communication as Discovery; and, (c) Communication as Cultivating Practice. Turk Talk requires students to use therapeutic communication skills to formulate their respo...

This is a narrative study of daily lives for families who have a member with a disability (famili... more This is a narrative study of daily lives for families who have a member with a disability (families with disability). Families with disability are often studied in a way that centralizes disability rather than personhood. The medical model and social models of disability work to create a framework of how disability might be viewed. However, these models are problematic because they have a tendency to cover over the smaller, more subjective stories of disability. Stories told by families with disability are important to tell, hear, and understand because they provide new and alternative ways of looking at life with disability. In this study, I interviewed families (being any group of people that consider themselves to be family) with disability. I conducted interviews with two or more members of five families who have a member with disability. Narrative analysis of data resulted in the writing of three stories that tell of daily life for families with disability. The stories are then...

This study addresses a significant clinical and social issue: self-injury among gay men. Self-inj... more This study addresses a significant clinical and social issue: self-injury among gay men. Self-injury can be understood as any act undertaken by the self to cause physical damage to the body without the conscious intent to die. The existing self-injury literature tends to focus on self-injury as a problem for women. That is to say, because more women than men self-injure, research focuses more strongly on their motivations and treatment needs. The literature that explores self-injury as it relates to gay men is not well developed and focuses strongly on suicidality and the risks associated with various self-injurious behaviours. This has produced useful information for some areas of practice such as risk management and public health suicide prevention strategies. What this literature has not done is explore the contexts and meanings of self-injury for this particular group. This study is a narrative inquiry, which explores gay men's self-injury through their experiences in contex...