Research Dialogues

Ingrid Handlovsky RN, PhD Assistant Professor, UVic School of Nursing
November 2, 2021 3:30-5:00pm PST

Advancing Equity with Gender and Sexual Identity: Using Strength-Based Approaches to Unpack the Historical and Ongoing Impact of Interpersonal and Structural Discrimination.

It is well established that men who self-identify as gay experience health inequities rooted in homophobia and heteronormativity. Despite evidence that gay men experience significant health concerns fuelled by discrimination, little is known about the processes men employ to manage their health (i.e. the variety of social practices geared towards promoting their health and navigating exacerbations of chronic illness). What is known has focused on gay men’s sexual health practices and adherence to HIV treatment regimens and is greatly informed by neoliberal discourses of ‘risk’. In this talk, I broach recognition of discrimination as a determinant of health and describe the processes by which discrimination has greatly influenced the health and illness practices as well as experiences of middle-aged and older gay men. Key foci include resilience, health management, mental health, and the socio-historical context of pre-treatment HIV. This knowledge is essential to inform extant and future health services along with health provider approaches to adequately and meaningfully support men’s capacities to promote and protect their health.

Dementia Reimagined: The Impact of the Arts in Challenging Stigma and Improving Health, Well-being and Quality of Life

The Dementia Inclusive Victoria initiative focuses on promoting a better understanding of dementia, reducing stigma, raising public awareness and facilitating social inclusion and participation within our community. Two research projects at UVic are creating intergenerational communities for creative engagement, learning, and social connection for persons living with dementia (Pwd) and their care partners: 1) the Voices in Motion (ViM) choir, a high-quality dementia inclusive choir; and 2) Memory Café Victoria, a comfortable social gathering focusing on creative engagement in activities that include story creation, music, poetry and movement.  In both programs, the focus is not on dementia but on creating a high quality arts-based program that fosters caring, support, and social connections.  Our research shows that the programs decrease loneliness, depression, caregiver distress, and the rate of cognitive decline.  Findings suggest that arts-based dementia programs are a cost-effective approach to reduce social isolation and stigma, and create a community of belonging and acceptance.  By emphasizing creativity and imagination, arts-based programs shifts attention away from declines associated with memory loss. They allow the PwD to live more fully now, giving hope in the absence of a medical cure.

Older adults with cancer: Exploring the ethical dimensions of geriatric oncology nursing practice

Canadians 70 and older comprise 46% of new cancer cases and 63% of cancer deaths: representing the fastest growing segment of Canadians. Within cancer care, older adults often face obstacles difficult to recognize, such as structural ageism and ethical issues embedded in necessary treatment and practice decisions. Compounding these complexities is the ageist assumption that the majority of this population is frail. Conversely, a majority of older adults present in oncology settings as fit and independent and are often not identified as geriatric, potentially effacing important developmental considerations for nursing practice. The focus of this research dialogue is to discuss insights arising from our current research into the ethical aspects of cancer care, which may contribute, to suboptimal care for older adults with cancer and their families. These findings highlight ethical dimensions of practice in oncology settings that must be re-examined in light of the current convergence of successful aging and increasing geriatric cancer incidence. Identifying gaps and issues is vital to contribute to advocacy and meaningful change to support this population to flourish while living with cancer and sequelae.

How to study digital clinical information systems and electronic patient portals: Reflections on theoretical frameworks, methodology, and opportunities and challenges in Canada

Digital health or eHealth is rapidly growing across Canada. This includes the Electronic Health Record (EHR) and online patient portals. Two major attitudes dominate the nursing literature on digital technology (and technology in general). Sociologists call these two sets of attitudes technological determinism (i.e., technology will over-power humanity) and social essentialism (i.e., technology is a blank slate fully dependent on human users to imbue it with meaning and significance). Some sociologists consider these perspectives inadequate to understand and analyze the complexity of technology-enabled health care practices. An alternative approach, sometimes called technology-in-practice, is exemplified by actor-network theory (ANT) and its current iteration known as “after ANT.” Key ANT assumptions include understanding technology as non-essentialist, agentic and enmeshed with other heterogeneous elements in practices. This understanding of technology unsettles the ‘human/non-human,’ ‘warm touch/cold technology’ binaries. In this presentation, I will review select nursing, sociological, and philosophical works articulating this alternative approach to studying technology. I will share examples from my funded research on the patient portal implementation in Alberta, Canada and reflect on challenges for conducting research focused on “real-world” implementation of digital health technology.

Personas as a knowledge translation tool to develop empathy

The challenge of translating research evidence into clinical practice are well-known, ranging from clinicians’ inability to attend education sessions (due to busy work schedules and staffing shortages) to the failure of the researchers to present findings in a way that is engaging, informative and reflective of real-world clinical contexts. Inspired to provide more effective knowledge translation resources, we created personas (i.e., avatars) with older adults with cancer (via empathy maps) to convey different stages and aspects of their health journey. In this talk, I will discuss how researchers can use personas to clarify assumptions and better understand the desires, motivations, and behaviours of patients by bringing out their true inner voice and strength.