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Biomedical subjects

Debra Morgan

Publications and source records attributed to Debra Morgan.

6 recordsLinked to original sources
PubMed2006

Rural and urban Canadians with dementia: use of health care services.

The purpose of this research was to examine the characteristics of older Canadians with dementia (compared to those without dementia), their use of health care services, and the impact of place (rural/urban) on use of services. Andersen and Newman's Behavioural Model of Health Services Use (1973) guided the study. A cross-sectional design used data from the Canadian Community Health Survey (CCHS) Cycle 1.1 (N=49,995 older Canadians; those with dementia=313). Results indicated that among Canadian females between the ages of 50 and 64, those with dementia were more likely than those without dementia to live in rural areas. Among females 80 years of age and over, those with dementia had higher levels of education and income than those without dementia. In addition, a higher proportion of white than of visible minority Canadians was afflicted with dementia. The results further suggest that Canadians with dementia primarily required support services and that they were more likely than persons without dementia to report that their health care needs were unmet. It is recommended that publicly funded national home care programs be expanded to ensure that the supportive services needed by this population are available.

Aged↗
PubMed2006

Insights from a national study.

Aboriginal registered nurses have been identified as an essential group in the delivery of health services in First Nations communities. Despite this, there is a lack of information about this group of nurses in Canada. This article presents information about this group taken from two components of a national study, The Nature of Nursing Practice in Rural and Remote Canada: documentary analysis and a national survey of nurses. The aboriginal nurse participants were predominantly female, between the ages of 40 and 49, diploma prepared and with licensure for less than 10 years. The survey data showed 41.4 per cent returned to their home communities to work. The participants noted how they enjoyed the challenges of rural and remote nursing and wanted to raise their families in these small communities. They have been able to create supportive work environments, particularly with their nursing colleagues. The nurses are committed to working in rural and remote communities.

Attitude of Health Personnel↗
PubMed2004

Grounded theory: reflections on the emergence vs. forcing debate.

AIM: The aim of this paper is to compare Glaser's model of theory generation, where theory rises directly and rigorously out of the data, devoid of interpretivism, to Strauss's conceptually descriptive approach that encourages directive questioning and supports an interpretive stance. BACKGROUND: The discovery of grounded theory (GT) was born out of a merger between Barney Glaser and Anselm Strauss, the proverbial 'fathers' of GT. Since the co-creation of their approach to theory development through research in 1967, these scholars have taken seemingly divergent paths in further developing and evolving the pragmatic use of GT. DISCUSSION: Numerous researchers have used GT as a general method, applying it to both quantitative and qualitative research approaches. In this paper we discuss the stages and strategies of data sampling, collection, coding and analysing used by both Glaser and Strauss. Constant comparative analysis is identified as the primary strategy in the integrated coding and analysing stages of this theorizing method, regardless of the researcher's philosophical or research orientation. We also discuss initial or open coding, advanced coding, memoing, and theoretical sampling, with particular attention to comparing and contrasting the descriptive terms and application strategies that have been suggested by both Glaser and Strauss. CONCLUSION: The reported distinctions in the approach, method, and general intent of GT reflected in this paper are not easy to comprehend. The two methods reflect different basic philosophical paradigms, and therefore represent distinct approaches to GT. Researchers need to be clear about which philosophy and resulting analysis approach they are using, and the effect that approach will have on the research process and outcomes.

Data Collection↗
PubMed2003

Breaks in continuity of care and the rural senior transferred for medical care under regionalisation.

Continuity of care, defined as the patient experiencing coherent care over time and place, is challenged when a rural senior with multiple medical problems is transferred to a regional hospital for acute care. From an illustrative case of an older patient with pneumonia and atrial fibrillation, we catalogue potential breaks in continuity of care. Optimal continuity of care is characterised not only by regular contact with the providers who establish collaboration with patients and their caregivers, but also by communication, co-ordination, contingency, convenience, and consistency. Because it is not possible to have the same providers continuously available (relational continuity), for continuity of care, there is a need for integrative system approaches, such as: (1) policy and standards, disease management programs, integrated clinical pathways (management continuity), (2) electronic health information systems and telecommunications technology (communication continuity). The evaluation of these approaches requires measures that account for the multi-faceted nature of continuity of care.

Journal Article↗
PubMed2003

Individual determinants of home-care nursing and housework assistance.

The purpose of this study was to examine individual determinants of use of publicly funded home-care nursing and housework assistance by Canadians 18 years and older from 1994 to 1999. Andersen and Newman's Behavioural Model of Health Services Use guided the selection of variables, analyses, and interpretation of the findings. Descriptive, correlation, and multiple logistic regression analyses were completed in each of the first 3 cross-sectional cycles of Statistics Canada's National Population Health Surveys. The determinants of use of housework assistance were older age, female, living alone, lower income, activity restriction, needing help with housework, not hospitalized in the previous year, and having at least 1 chronic condition. The determinants for home nursing tended to be the opposite of those for housework assistance. Between 1994 and 1999, use of housework assistance appeared to decrease and use of nursing services appeared to remain relatively stable. The findings underscore the need to target these 2 discrete subgroups of home-care users and ensure that funding is directed at support services as well as nursing services.

Activities of Daily Living↗