Biomedical subjects

Carol McWilliam

Publications and source records attributed to Carol McWilliam.

5 recordsLinked to original sources

PubMed2006

A meeting of minds: interdisciplinary research in the health sciences in Canada.

Brought together by the newly formed Canadian Academy of Health Sciences (CAHS), recognized national leaders in the 6 health sciences disciplines consider the environment for conducting interdisciplinary health research (IDHR) in Canada. Based on first-hand knowledge and thoughtful reflection, the authors argue that although much progress has been made in support of IDHR in Canada, the practical experience of researchers does not always bear this out. This article examines government, industry and academia to identify the cultural and structural characteristics that demand, promote or prevent IDHR in each sector. At its heart is the question, How can universities best support and enhance IDHR, not only for the benefit of science, but also to meet the growing needs of industry and government for intellectual capital? Focusing on the predominant health sciences disciplines, the authors define IDHR as a team of researchers, solidly grounded in their respective disciplines, who come together around an important and challenging health issue, the research question for which is determined by a shared understanding in an interactive and iterative process. In addition, they suggest that IDHR is directly linked to translational research, which is the application of basic science to clinical practice and the generation of scientific questions through clinical observation. This analysis of academic, industry and government sectors is not intended to offer rigorous data on the current state of IDHR in Canada. Rather, the goal is to stimulate research-policy dialogue by suggesting a number of immediate measures that can help promote IDHR in Canada. Recommended measures to support IDHR are aimed at better resourcing and recognition (by universities and granting agencies), along with novel approaches to training, such as government-and industry-based studentships. In addition, we recommend that professional organizations reconsider their policies on publication and governance. Although intended to maintain professional scopes of practice, these policies also serve to entrench disciplinary boundaries in research. We conclude by suggesting a number of research questions for a more rigorous assessment of the climate for IDHR in Canada. We call for an inventory and comparative analysis of academic centres, institutes and consortiums in Canada that strive to facilitate IDHR; an examination of the impact of professional organizations on health research, and on IDHR in particular; and a systematic review of research training opportunities that promote IDHR, with a view to identifying and replicating proven models.

Canada↗

PubMed2006

Client-centred empowering partnering in nursing.

AIM: This paper explores nurses' experiences 1 year after an organization's commitment to providing a client-centred and client-empowering partnering approach to care. BACKGROUND: Historically, nurses' approach to providing care in all nursing contexts has been one of doing for clients, and previous studies have focused more on in-hospital care than on home care. However, the isolation inherent in in-home nursing and nurses' limited professional autonomy and power associated with physician control over patients in home care have been reported, as has their difficulty in finding the meaning and satisfaction of human connectedness and mutuality in nurse-client relationships. Overall, research to date does not inform us about how nurses might make a change toward a more client-centred and client-empowering approach to nursing. METHODS: An interpretive phenomenological design was used to elicit in-depth understanding about Registered Nurses' experiences of providing care using this innovative empowerment model. A purposefully selected sample of eight Registered Nurses participated in in-depth interviews. Data were generated during 2002. Hermeneutic analysis was used to elicit themes and patterns emerging from the data. FINDINGS: Caring, client-centredness and the context of in-home care were important in implementing the new partnering approach. Barriers encountered at system, organizational and personal levels distracted nurses from fully comprehending and enacting the approach. After a year, they had begun to contemplate potential strategies for partnering with clients, but had not yet explored the power of their professional autonomy. CONCLUSION: Nurses are inclined to practise within the expert model of service delivery. They need to work through issues of professional autonomy and rise to the challenge of exercising their autonomy within the current healthcare context if they are to attend more consistently to client-centred empowering partnering. The home care setting offers an excellent environment for achieving these aims.

Adult↗

PubMed2004

Comparative costs of home care and residential care.

PURPOSE: This paper reports on Canadian research that examined the cost effectiveness of home care for seniors as a substitute for long-term institutional services. DESIGN AND METHODS: Two Canadian cities were included in the research: Victoria, British Columbia, and Winnipeg, Manitoba. The research computes the costs of formal care and informal care in both settings and ensures comparable groups of clients in both settings by comparing individuals at the same level of care. RESULTS: The results reveal that costs were significantly lower for community clients than for facility clients, regardless of whether costs only to the government were taken into account or whether both formal and informal costs were taken into account. When informal caregiver time is valued at either minimum wage or replacement wage, there was a substantial jump in the average annual costs for both community and facility clients relative to when informal caregiver time was valued at zero. IMPLICATIONS: Nevertheless, the results reveal that home care is significantly less costly than residential care even when informal caregiver time is valued at replacement wage.

Aged↗

PubMed2004

Consumer participation in the employment rehabilitation process: contextual factors and implications for practice.

Rehabilitation models of practice have emerged that offer persons' with disabilities opportunities to have an active role in the work entry or re(entry) process. Despite the growth and interest in empowering client involvement in practice, consumer views on the determinants of participation are not fully understood. Thus, consumer feedback on using a self-directed approach to employment rehabilitation was elicited to identify factors integral to their participation in the process. Focus groups were conducted with 35 adult consumers with developmental, mental health, physical and learning disabilities to gain insights into their involvement in a participatory approach to find employment. Content analysis of data revealed barriers and facilitators, which hindered or enabled consumer involvement in the vocational service process. This article discusses the importance of considering issues across the rehabilitation system, practice and lived contexts when implementing participatory approaches in vocational rehabilitation settings.

Adult↗

PubMedDate not supplied

Patient empowerment after total hip and knee replacement.

PURPOSE: This research was designed to gain an enhanced understanding of empowerment within in-home care relationships after hospital discharge of elderly patients who had undergone total hip or total knee replacement. METHOD: An interpretive phenomenology method was used. SAMPLE: Nine participants were interviewed on audiotape, guided by a semistructured interview guide. Five themes emerged centering on a strong desire to maintain independence. Overall, participants experienced disempowered relationships with professional in-home care providers and a more equitable empowered relationship with nonprofessional care providers. CONCLUSION: Disempowered relationships with professional personnel were not identified as a dissatisfier to most participants. Rather, patients expressed deference to the traditional expert model of healthcare. Further investigation is needed to understand the effect of empowerment on client satisfaction and clinical outcomes.

Activities of Daily Living↗