Marilyn Evans - Academia.edu (original) (raw)

Papers by Marilyn Evans

International Journal of Nursing Education Scholarship, Jun 29, 2005

In 2000, one Canadian university began offering a 12-month baccalaureate program to provide regis... more In 2000, one Canadian university began offering a 12-month baccalaureate program to provide registered nurses (RNs) with a condensed program to expedite baccalaureate preparation. The paucity of current literature regarding returning RNs experiences emphasized the need to explore these students perceptions regarding their educational experiences. Twelve participants were interviewed for this descriptive/exploratory study. A major theme of &quot;surviving&quot; emerged from the qualitative analysis. Surviving embraced the themes of &quot;the quest&quot;, &quot;the struggle&quot;, and &quot;the aftermath&quot;. Implications for nursing curriculum and program development and recommendations for research are discussed.

Rural and Remote Health, Jan 30, 2016

Heterosexual female adolescents' decision-making about sexual intercourse and pregnancy in rural ... more Heterosexual female adolescents' decision-making about sexual intercourse and pregnancy in rural Ontario,

Journal of Developmental Origins of Health and Disease, Jun 23, 2020

Currently, there is limited knowledge on how health care providers perceive and understand the De... more Currently, there is limited knowledge on how health care providers perceive and understand the Developmental Origins of Health and Disease (DOHaD), which may impact how they inform patients and their families throughout the perinatal period. This qualitative descriptive study explored if and how health care providers counsel on in utero programming and future health outcomes with parents, both preconception and during pregnancy. One-on-one, semi-structured interviews were conducted with 23 health care providers from varying health disciplines including obstetrics and gynaecology, midwifery, paediatrics, endocrinology and internal medicine. Audiotaped interviews were transcribed verbatim and analysed using inductive thematic analysis. Three themes were identified: Knowledge about DOHaD, Counselling on DOHaD in Practice Settings and Impact of DOHaD on Health. Health care providers not only expressed excitement over the potential health benefits of DOHaD counselling but also indicated barriers to knowledge translation, including a lack of knowledge among providers and a disconnect between basic scientists and practitioners. All health care providers expressed concerns on how and when to introduce the concept of DOHaD when counselling patients and called for the development of practice guidelines. Counselling on DOHaD needs to be framed in a way that is empowering, minimising the potential of coercion and guilt. More interaction and collaboration are needed between health care providers and researchers to identify strategies to support knowledge translation generated from DOHaD research into practice settings.

Journal of Obstetric, Gynecologic, & Neonatal Nursing, Nov 1, 2015

Objective: To determine the satisfaction of pregnant women who presented at a triage unit in an o... more Objective: To determine the satisfaction of pregnant women who presented at a triage unit in an obstetric birthing care unit with obstetric triage services. Design: Qualitative descriptive with conventional content analysis. Setting: Individual audio recorded telephone interviews with women after discharge from a tertiary care hospital's obstetric triage unit. Participants: Purposive sample of 19 pregnant women who had received obstetric triage services. Methods: A semi-structured interview guide was used for data collection. All interviews were audio-taped and transcribed verbatim. Data analysis was consistent with qualitative content analysis with open coding to categorize and develop themes to describe women's satisfaction with triage services and care.

Nursing Research, Sep 1, 2002

Background: Despite ongoing investigations into specific causes of and treatments for pregnancy-r... more Background: Despite ongoing investigations into specific causes of and treatments for pregnancy-related nausea and vomiting, it remains a common phenomenon of varying intensity that affects the quality of life for both affected women and their families. Objective: To understand how women cope with severe nausea, vomiting, and/or retching during pregnancy. Method: Women hospitalized with severe symptoms (N ϭ 24) were purposely selected to participate in 24 semistructured interviews and one focus group (N ϭ 4). Results: A process was identified wherein women experienced severe and unrelenting nausea and related symptoms which became progressively more debilitating, leaving them feeling uncertain about when and if they would recover. This caused the women to isolate themselves from their world in an effort to cope with symptoms. Conclusions: Severe nausea and vomiting of pregnancy is a complex and overwhelming syndrome. Rather than emphasizing a specific treatment for a particular symptom (e.g., vomiting), nurses can intervene to reduce the impact of factors that affect the magnitude of nausea, vomiting, and retching.

Journal of Nursing Education, Apr 1, 2010

A university nursing program in Ontario, Canada initiated the process of implementing the Registe... more A university nursing program in Ontario, Canada initiated the process of implementing the Registered Nurses' Association of Ontario best practice guideline (BPG) on smoking cessation into the curriculum. This study explored nursing students' and clinical instructors' perceptions regarding the implementation of the BPG in their practice to support faculty in the development of a curriculum that promotes smoking cessation and the competencies necessary for graduates to implement health promotion skills in practice. Four student nurses and two clinical instructors participated in semistructured interviews. Four major themes were identified through the data analysis process: personal and professional self, health “preaching,” developmental perspective, and environmental constraints. This study presents a curricular model for health promotion practice incorporating the components of primary health care, health promotion counseling, smoking cessation BPG, and sociopolitical context.

International journal for human caring, Jun 1, 2005

This descriptive study explores the concept of caring in nursing education from the students’ per... more This descriptive study explores the concept of caring in nursing education from the students’ perspective. Students were asked to share moments of caring that they experienced in a nursing course. A content analysis revealed a relational nature of humanistic caring demonstrated by the following themes: connectedness, presence, growth, and respect. Results identified caring as relational and being connected with other; that is, caring is grounded in nurse-educator-student relationships.

Qualitative Health Research, 2005

Being diagnosed with gestational diabetes (GDM) is coupled with the implication that the woman an... more Being diagnosed with gestational diabetes (GDM) is coupled with the implication that the woman and her fetus are at risk. In this study, the authors use a hermeneutic phenomenological approach to gain an in-depth understanding of GDM as pregnant women meaningfully experience it. They conducted conversational interviews with 12 women who were diagnosed with and being treated for diabetes in pregnancy. Data analysis involved a reflective process consistent with the guidelines of thematic analysis. Four themes identified as characteristic of the women’s pregnancy experience were Living a Controlled Pregnancy, Balancing, Being a Responsible Mother, and Being Transformed. The findings challenge health care professionals to discuss openly and reassess their present models of care for pregnant women and their families.

First Peoples Child & Family Review, Oct 5, 2021

This study employed a critical narrative approach to examine the experience of Aboriginal Veteran... more This study employed a critical narrative approach to examine the experience of Aboriginal Veterans in Canada adopted and/or fostered during the Sixties Scoop. The objectives of this study was to: 1) understand lived experiences of Aboriginal veterans adopted and/or fostered during the Sixties Scoop, 2) investigate health needs articulated by this population, and 3) provide suggestions for the creation of health services to aid Aboriginal veterans adopted and/or fostered during the Sixties Scoop with their health needs. Individual interviews were audio-recorded and conducted with eight participants from across Canada. All interviews were transcribed verbatim and analyzed using the holistic-content model (Lieblich, Tuval-Mashiach & Zilber, 1998). Data analysis of the interviews uncovered three overarching themes: a) sense of belonging, b) racism: experienced and perceived, and c) resilience: not giving up in the face of adversity. Two main health needs conveyed by the participants included mental health care and support to fight substance abuse. More awareness regarding the historical realities experienced by this population and the impact this may have on their overall health is needed. Increased coordination between Veterans Affairs Canada (VAC), Royal Canadian Legion (RCL), National Aboriginal Veterans Association (NAVA), Aboriginal Veteran Autochthones (AVA), and Aboriginal agencies is needed to address the mental health needs experienced by this group of veterans.

Nursing Ethics, Apr 8, 2014

Objective: To increase our understanding of moral distress experienced by neonatal registered nur... more Objective: To increase our understanding of moral distress experienced by neonatal registered nurses when directly or indirectly involved in the decision-making process of resuscitating infants who are born extremely premature. Design: A secondary qualitative analysis was conducted on a portion of the data collected from an earlier study which explored the ethical decision-making process among health professionals and parents concerning resuscitation of extremely premature infants. Setting: A regional, tertiary academic referral hospital in Ontario offering a perinatal program. Participants: A total of 15 registered nurses were directly or indirectly involved in the resuscitation of extremely premature infants. Methods: Interview transcripts of nurses from the original study were purposefully selected from the original 42 transcripts of health professionals. Inductive content analysis was conducted to identify themes describing factors and situations contributing to moral distress experienced by nurses regarding resuscitation of extremely premature infants. Ethical considerations: Ethical approval was obtained from the research ethics review board for both the initial study and this secondary data analysis. Results: Five themes, uncertainty, questioning of informed consent, differing perspectives, perceptions of harm and suffering, and being with the family, contribute to the moral distress felt by nurses when exposed to neonatal resuscitation of extremely premature infants. An interesting finding was the nurses’ perceived lack of power and influence in the neonatal resuscitation decision-making process. Conclusion: Moral distress continues to be a significant issue for nursing practice, particularly among neonatal nurses. Strategies are needed to help mediate the moral distress experienced by nurses, such as debriefing sessions, effective communication, role clarification, and interprofessional education and collaboration.

Applied Nursing Research, Jun 1, 2021

BACKGROUND This paper focuses on the identified value of a community-based project (CBP), includi... more BACKGROUND This paper focuses on the identified value of a community-based project (CBP), including residents' living within low income housing units and their reported experiences of receiving health and social services within two communities by nurse practitioners (NPs) and its impact on their communities. OBJECTIVE To gain insight into the lived experience of residents in the housing units from a collaborative interprofessional care approach provided in a clinic situated within each housing unit, in integrating health and social services within the residents' own 'community' and its outcomes. DESIGN A qualitative descriptive study to gain insight into the shared views of care informants. SETTINGS Two low income housing units in xxxxxxxxxxxxxxxxxxxx. PARTICIPANTS Twenty-two residents representing all genders who lived in the housing units. METHODS A purposive sampling of willing residents participated in a focus group interview. Each group comprised from 4 to 6 persons. Two focus group interviews occurred in each of the two housing units. RESULTS Their voices resulted in identification of two themes - clinic as a catalyst to creating a sense of community and clinic as assisting them in managing their overall health. Two subthemes were also identified within each theme. CONCLUSION Findings provide insight into the value of CBP, that a strengths-based and interprofessional care approach can serve as a catalyst for an evolving community.

BMC Pregnancy and Childbirth, Jul 24, 2017

Background: Perinatal depression is the most common mental illness experienced by pregnant and po... more Background: Perinatal depression is the most common mental illness experienced by pregnant and postpartum women, yet it is often under-detected and under-treated. Some researchers suggest this may be partly influenced by a lack of education and professional development on perinatal depression among health-care providers, which can negatively affect care and contribute to stigmatization of women experiencing altered mood. Therefore, the aim of this systematic review is to provide a synthesis of educational and professional development needs and strategies for health-care providers in perinatal depression. Methods: A systematic search of the literature was conducted in seven academic health databases using selected keywords. The search was limited to primary studies and reviews published in English between January 2006 and May/June 2015, with a focus on perinatal depression education and professional development for health-care providers. Studies were screened for inclusion by two reviewers and tie-broken by a third. Studies that met inclusion criteria were quality appraised and data extracted. Results from the studies are reported through narrative synthesis. Results: Two thousand one hundred five studies were returned from the search, with 1790 remaining after duplicate removal. Ultimately, 12 studies of moderate and weak quality met inclusion criteria. The studies encompassed quantitative (n = 11) and qualitative (n = 1) designs, none of which were reviews, and addressed educational needs identified by health-care providers (n = 5) and strategies for professional development in perinatal mental health (n = 7). Consistently, providers identified a lack of formal education in perinatal mental health and the need for further professional development. Although the professional development interventions were diverse, the majority focused on promoting identification of perinatal depression and demonstrated modest effectiveness in improving various outcomes. Conclusions: This systematic review reveals a lack of strong research in multidisciplinary , sector, site, and modal approaches to education and professional development for providers to identify and care for women at risk for, or experiencing, depression. To ensure optimal health outcomes, further research comparing diverse educational and professional development approaches is needed to identify the most effective strategies and consistently meet the needs of health-care providers.

Patient Education and Counseling, Jun 1, 2012

Social support has a positive influence on women&amp;amp;amp;amp;amp;#39;s childbearing e... more Social support has a positive influence on women&amp;amp;amp;amp;amp;#39;s childbearing experience and is shown to be a preventive factor in postpartum depression. This study examined the perceived value and types of social supports that characterize the discussions of women who participate in postpartum depression online discussion groups. A directed content analysis was used to examine 512 messages posted on a postpartum depression online support group over six months. The majority of the women&amp;amp;amp;amp;amp;#39;s postings illustrated emotional support followed by informational and instrumental support. Online support groups provide women experiencing postpartum depression a safe place to connect with others and receive information, encouragement and hope. Education strategies are needed to address the many questions regarding PPD medical treatment. Recommending vetted links to PPD online support groups will create opportunities for women to share their experiences and obtain support.

Canadian Maternity, Newborn & Women's Health Nursing - Libros de Medicina - Enfermeria ma... more Canadian Maternity, Newborn & Women's Health Nursing - Libros de Medicina - Enfermeria materno-infantil - 88,00

International Journal of Nursing Education Scholarship, Jan 5, 2012

The mandala is a circular art form used by psychologists to access subconscious thought through s... more The mandala is a circular art form used by psychologists to access subconscious thought through symbolism and it has recently been adopted by nurse educators as a learning strategy for self-awareness. The lived experiences of six first-year undergraduate nursing students who completed a mandala assignment for emotional learning were explored using hermeneutic phenomenology. Participants experiences diverged from their original expectations that the mandala assignment would allow for a fun and free expression of 'self'. Participants did describe experiences of self-discovery; however, their experiences also resembled those associated with socialization in nursing education. Participants described both self-reflection and critical-reflection while completing the mandala assignment. Nurse educators and researchers can gain insight regarding the use of this assignment as an integrated transformative learning approach for emotional learning.

Canadian Journal of Diabetes, 2010

OBJECTIvES: 1) To explore the health behaviours of women with recent gestational diabetes mellitu... more OBJECTIvES: 1) To explore the health behaviours of women with recent gestational diabetes mellitus in the first year postpartum; and 2) to compare their perceived health status with their actual experiences in establishing and maintaining healthy lifestyle changes. METhODS: A concurrent mixed method design using semistructured interviews, supplemented by the Short-Form 36 (SF-36) Health Survey, diet recall and activity-level records collected at multiple intervals. RESULTS: A total of 16 women rated their general health (SF-36) as good or very good, but diets rarely met Canada's Food Guide recommendations. Narratives revealed initial experiences of abandonment and uncertainty with respect to staying healthy and moving on at 1 year. Continuing support and education postpartum were identified as being needed to maintain changes made during pregnancy. CONCLUSIONS: Participants acknowledged their increased risk for type 2 diabetes and were cognizant of health behaviours that might prevent diabetes; however, sustaining lifestyle changes in diet and activity were described as difficult.

Journal of Holistic Nursing, Apr 30, 2013

The purpose of this research study was to gain an understanding of the lived experience of everyd... more The purpose of this research study was to gain an understanding of the lived experience of everyday anxiety among adolescents during high school. An interpretative phenomenological approach as articulated by Merleau-Ponty (1962) and Van Manen (1998) was utilized for this study. A purposive sample of 8 adolescent males and females were interviewed. Data analysis was undertaken throughout the research study by utilizing a thematic analysis of text in which themes emerged to document and understand the lived experience of everyday anxiety among adolescents during high school. The study revealed themes reflective of the lived body in time, space and in relations with others. The three themes were 1. The embodied experience of anxiety with the subthemes of the body responds and the constant running mind of worry and fear; 2. Feeling uncomfortable in the lived space of school with the subthemes of the lived relations of bullying, the internal/external space of isolation, the constant pressure to perform well, and life will get better and; 3. Life at home with the subthemes of the lived space of home and the lived relations of pressure from parents. Conclusions from the study revealed areas of improvement for the healthcare and school systems, implications for nursing education, practice and future research.

Nursing Ethics, Sep 1, 2004

Genetic counseling is viewed as a therapeutic interrelationship between genetic counselors and th... more Genetic counseling is viewed as a therapeutic interrelationship between genetic counselors and their clients. In a previous relational ethics research project, various themes were identified as key components of relational ethics practice grounded in everyday health situations. In this article the relational ethics approach is further explored in the context of genetic counseling to enhance our understanding of how the counselor-client relationship is contextually developed and maintained. Qualitative interviews were conducted with six adult clients undergoing genetic counseling for predictive testing. Engagement, dialogue and presence were revealed as relevant to genetic counselor-client relationships. A relational ethics approach in genetic counseling challenges the concept of nondirectiveness and may enhance the outcome of counseling for both counselor and client.

International Journal of Africa Nursing Sciences

Applied Nursing Research