Tag Archive for: nursing

Behind the Science: Moving the Microscopic Lens to Marginalized Populations

Interviewee: Emmanuela Ojukwu (RN, PhD), Assistant Professor of Nursing, University of British Columbia. Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators).

Published: November 18th, 2022

Could you briefly explain your career trajectory from a Registered Nurse to now an Assistant Professor?

Towards the end of obtaining my Bachelor of Science Degree in Nursing, I knew that I wanted to pursue a career in women’s health. As my journey progressed, I would eventually get accepted to a PhD program where I had the opportunity to work with a professor who was internationally recognized, with a track record of success in improving minority women’s health with a focus on social determinants of health. The decision to focus on HIV came during my RN experiences at a Perinatal HIV clinic for vulnerable populations, wherein I observed birthing parents living with HIV, to be lost to follow-up to their own care but continually engaged in their infant’s care, postpartum. Possibly due to maternal instincts, but the focus on their infants and not themselves was very apparent. This spurred the idea for what would eventually become my dissertation. So, I wanted to see what factors deterred them from engaging in their own care or factors that motivated them to go in (for those that did). Also, as a natural empath – sometimes to a fault – I would find myself really vested in their care, particularly, for the marginalized women, e.g, new immigrants/refugees, racialized populations, homeless. Most of the patients who were lost were within these categories, so it was important to note the possible intersections in their marginalized identities, which were causing their suboptimal engagement in treatment and possible impediments to their overall wellbeing. When I applied to UBC, I definitely wanted to continue with HIV research, although, I realize that HIV rates here compared to the US are relatively less, but it’s still present. And, as there is currently no treatment that completely eliminates the virus, the likelihood of transmission and/or increasing morbidity and mortality,is significantly reduced with effective treatment/management. I remain vested in this topic as a researcher, and would describe my work as focusing on health equity and social determinants of health for vulnerable populations, marginalized by race, sex, gender, disabilities such as HIV, and other psychosocial vulnerabilities.

Why did you choose to study marginalized populations and sexual health?

Asides from being such an empath, I think that I’ve had my own lived experiences of discrimination within the healthcare setting, both as a patient and a healthcare provider. I, sometimes, find that there are “sexual and reproductive health stereotypes” that follow “black women” and these often go before them upon their arrival to any hospital/clinical setting. As a patient, I can count times this has been the case for me; and not until I divulge my profession in healthcare do I get treated any differently. As a provider, the discrimination can stem from patients or colleagues with preconceived, underrated expectations of racialized peoples’ performances, and hence a lack of trust in their abilities as providers, and also unequal (or mostly, subdued) access to and opportunities for growth and development within their various units. All of these experiences, and their impacts on wellbeing demonstrate a critical need for research with and for persons on both sides of the table. By doing this work with and for patients who may fit within these identity brackets, especially for topics that could be stigmatizing such as sexually transmitted infections and HIV, I hope to amplify their voices and create an awareness of their situations. I hope that in creating such an awareness of the existing disparities and inequities; and with the development of interventions, put in place by healthcare providers, public health officers, and even the government; that there might be opportunities to rebuild some of the trust which may have seemed lost in the system, by these communities.

How does Women’s Health specifically intersect with your work at the moment?

Women’s health is at the center of everything I do in my research. A lot of my work focuses on the sexual and reproductive health of women. I currently have two ongoing studies; one, examining the impacts of COVID-19 on quality of life for African, Caribbean, and Black women living with HIV in BC; and another exploring the impacts of racism, sexism, and psychosocial vulnerabilities on access to care services for African, Caribbean, and Black women living with HIV. While I have a special interest for racialized women, I do not shy away from work focusing on the psychosocial and sociostructural factors influencing equitable care for all women. Merely existing in a patriarchal world as a woman can interfere with several aspects of wellbeing. The impacts of other layers of marginalization can have very lasting, detrimental effects on the lives of persons who fit within these identity brackets. Examining the impacts of these intersecting, underprivileged identities and unpacking the various layers and layers of vulnerabilities that surface, is at the core of my research. So in essence, the makeup of a woman’s sexual and reproductive health, and how that interferes with and/or allows them to exist inclusively in a very patriarchal system is of importance to me.

What impact do you hope to see with your work years from now?

I’m hoping that knowledge generated from my work can have lasting positive impacts in the way that care is modified/adjusted for the affected populations. Not surprisingly, there isn’t a lot of data on marginalized populations when it comes to women’s reproductive health, whether it’s rates of maternal mortality or anything else, in Canada. I’m hoping that my research can contribute to bridging those gaps and generating these data, so that researchers, community leaders, healthcare providers, the government, and others in positions of power may be alerted to these situations and help to effect change. We know that these issues exist but the paucity of data and research in this area limits the opportunities for interventions that are culturally-sensitive and -safe. I hope that my research in the short run, can be a “call to action” and in the long run can lead to sustainable “actions for change” for enhancing women’s equitable health.

Where can people find your work?

My email, usually, is the best way to contact me, at emmanuela.ojukwu@ubc.ca.

Behind the Science: Promoting Women’s Mental HealthThrough Social Interventions

Authors: Romina Garicia de leon and Negin Nia, Women’s Health Blog Coordinators | Interviewee: Dr. Saima Hirani, Ph.D., University of British Columbia

Published: September 9th, 2022 

Can you please tell us a bit about your career trajectory as a registered nurse, and now Assistant Professor of Nursing?

I’m an internationally educated nurse. I completed my Bachelors of Science and Master of Science in Nursing from The Aga Khan University in Pakistan. I began  my nursing career as an intensive care unit and cardiac intensive care unit nurse in Pakistan, which involved a lot of technical, high tech, critical care.

I then came to Canada and completed my PhD in Nursing with a focus on mental health at the University of Alberta. After PhD, I went back to Pakistan and worked as an Assistant Professor in the Aga Khan University. In 2019, I joined University of British Columbia (UBC) as a postdoctoral research fellow and currently, I am Assistant Professor,  at UBC,  School of Nursing.

What got you interested in Mental health Nursing? 

After I started working in the ICU, I got some experience with mental health nursing and I got to work with a variety of women, some of whom were incarcerated, survivors of sexual assault or domestic violence. This got me interested in mental health, and many of my teachers recommended me to enter the field.  In 2007, I joined a multidisciplinary research project as a co-investigator that aimed to promote mental health and empowerment in women. My master’s thesis was also part of that larger project. By the time I came to Canada for my PhD, it was very clear that I wanted to focus on women’s health and mental health specifically. My PhD focused on development and testing of social support intervention for women’s resilience and quality of life. My program of research mainly focuses on mental health promotion of individuals including women who live in socioeconomic disadvantaged settings. 

You recently published a paper on COVID-19 and its effects on mental health. Can you elaborate on that study? 

So that was a team that I was working with during my postdoctoral work. Dr. Emily Jenkins led this work which was about the impact of COVID-19 on Canadian Mental Health. The first findings that we published showed  an anticipated change in mental health issues among the population, and especially women experienced more mental health issues than men, globally. COVID-19 has affected women badly, as we all know there are some social issues at play. For example, many working women were also taking care of kids at home so there is a double burden. Sex differences were also observed for employment losses i.e. women’s employment has been affected more than men.There’s actually a layer of complexity into women’s well being and in turn the well being of the families and the children. 

You touched a bit on this, but why is women’s health important to you?

Women’s Health has been very close to me for a long time. This passion started when I was a master’s student 15 years ago. I actually joined a multidisciplinary research team back in Pakistan, and it was made up of nurses, psychologists, and psychiatrists. The team’s goal was to develop and test economic skill building and life skill interventions for women, and that’s where my masters thesis came from. So I actually developed and tested that lifestyle building intervention and tested it for feasibility. Intervention development is not an easy task, I went through a lot  of literature, and interviewed several women who were living in some more vulnerable conditions, and some low socio economic communities. I would go to the urban slum areas of Karachi, Pakistan to work with these women. I learnt a lot from these women, it was a life changing experience for me. That was what laid the foundation for my work. After 15 years, I’m still very passionate about that work. 

And the way I think about it is, there are the two main reasons women’s health is important. The first and foremost is, women’s health is directly linked with the children and families health, which is the cornerstone of a family’s overall health. Working in different contexts  of Pakistan and Canada, I learnt that  in general women and mothers play the same roles across countries. There are some universal gender roles attached to women, therefore, women’s mental health is directly associated with their children’s wellbeing.  To pay attention to women’s health and well being is to make children’s lives better and create healthier families. 

And the second reason to focus on women’s health is the high prevalence and high risk of developing certain health challenges among women, as women experience unique healthcare issues more than men. Such as reproductive health issues, violence and abuse, depression and anxiety. These issues are more prevalent globally, and not only in low and middle income women. Moreover, women don’t just experience higher prevalence to diseases but more barriers in accessing  health care than men. Some women may lack economic independence in certain countries, meaning no or lack of education opportunities, or unemployment. If women don’t have the freedom to decide for themselves, this creates a large barrier to reach out for help and support.  Mostly, I’ve seen these issues come up in Pakistan, when women get married. A lot  of attention goes to their families and children, leading them to overlook their own health. So I think this realization and awareness drove the focus of my research, and to empower women, and help them prioritize their health. 

Where can people go to learn more about the work that you do? 

I have  twitter @HiraniSaima and people can look at my Google Scholar or PubMed. 

 

Behind the Science: New Ways of Investigating Ovarian Cancer Prevention


Interviewee: Alex Lukey, PhD, University of British Columbia, School of Population and Public Health. Authors/Editors: Negin Nia & Romina Garcia de leon (Blog Co-coordinators).

Published: August 12th, 2022.

Alex Lukey, a previous Women’s Health Research Cluster (WHRC), Blog Co-coordinator is speaking to us about her work on ovarian cancer prevention. Lukey is working on preventing ovarian cancer using big data and machine learning. Read more to find out about her work and how she got into the women’s health field.

Could you please tell us about your current research?

The lab that I work in studies ovarian cancer, specifically the prevention aspect. So, the project that I am going to be working on focuses on using the big datasets that are in BC to try and predict ovarian cancer. This is to possibly make recommendations in a clinical setting regarding prevention efforts. 

My supervisor, Dr. Gillian Hanley, works around opportunistic salpingectomy. In the last 10 years or so the research found that a lot of ovarian cancers start on the fallopian tube rather than the actual ovaries. So, about 10 years ago a team in BC started doing opportunistic salpingectomies. This means if someone goes into another gynecological surgery, and they are done having kids (or don’t want any), they can have their fallopian tubes taken out by choice, at the same time.

We now have studies that show that removing the fallopian tubes is effective at preventing the most common and deadly form of ovarian cancer. My PhD will be looking at this and seeing if we can take this a step further by possibly targeting people who are at higher risk. I am also going to be doing qualitative research because it is a big decision to undergo surgery and to make that decision as a patient – but this is why the research is needed.

What sparked your interest to pursue this work?

I have always been interested in women’s health research. My Master’s in nursing at UBC Okanagan focused on improving heart failure self-care through gamified education which so my PhD work is pretty different, but even back in nursing school I volunteered at the Options for Sexual Health Clinic. So, I have always been interested in making women’s health research more equitable because there are so many big gaps.

Before my PhD I was working with Dr. Hanley on a project that was looking at hormone replacement therapy on a grant I was awarded called the CIHR Women’s Health Clinical Mentorship Grant. After that, I decided to keep working with Dr. Hanley as my PhD supervisor because she’s a fantastic researcher and her lab focused on my interests of ovarian cancer and population-based data. I knew I wanted to work in big datasets for my PhD because there are many opportunities to translate research into provincial, national and even international knowledge and answer important research questions. 

How do you hope this research will impact the women’s health field?

For me, the most tangible impact would be that we are allowing patients to make that decision regarding preventing ovarian cancer around their own bodies and health. Before we can offer salpingectomy at a greater scale for preventing ovarian cancer though more work needs to be done. This is totally an individual decision, but I want people to be able to take their health into their own hands.

The cancer survival rate has not really moved much in the last 30 years. There have been better treatments and drugs coming out. But the five year survival rate of ovarian cancer is still less than 50 per cent which is pretty abysmal. This also affects a lot of people on the younger side, in their 50 or 60’s. It’s a very deadly and devastating disease and often has major long term health impacts for those who do survive. Survivors can have their quality of life impacted through things like sexual dysfunction, bowel dysfunction, and continuing pain just to name a fewy. So, we are just trying to help prevent ovarian cancer from happening in the first place.

Did any of this tie into the work you did with the WHRC as a Blog Co-coordinator?

I definitely would say that, when I was a blog coordinator it was a really great experience to learn about a lot of different research areas. It was also really cool to see what other people were working on. I learned about so many impressive research projects going on in women’s health. And it’s really exciting to see so many really motivated researchers out thereIn research, you often have to just pick your little area and kind of stay focused on that. But I think it was really exciting to see how many different areas are being addressed even just in BC and Canada.

Is there anything else you are currently working on?

I am still helping out with the trainee research presentation for the WHRC. We just had one in June and we will likely have another in September. I love hearing about more research being done in the field of women’s health and it is an opportunity for trainees ranging from undergrad to post-doc to showcase their work and practice presenting. So, if anyone wants to participate in that, then they can reach out to me.

Where can people find you and your work?

I’d be happy to connect on Twitter so I can be found at @AlexandraLukey there for any questions. If people are more interested in the research aspect of things feel free to email me alukey@mail.ubc.ca

Behind the Science with Eunice Bawafaa

Authors: Arrthy Thayaparan and Alex Lukey (Blog Coordinators) Interviewing: Eunice Bawafaa, RN, MSTTI, MScN, Phd Student, UBC

Published: May 7th, 2021

Our next installment of the Behind the Science features Eunice Bawafaa. Not only is Eunice a talented PhD student, but she is also a registered nurse passionate about improving the health of women in Sub-Saharan Africa.

Eunice “sat down” with Alex over zoom from her home in Ghana to talk about her research journey.

How did you become interested in the work you’re currently doing?

I have worked for the past twelve years as a registered nurse in Ghana. In my capacity as an RN, I have worked in several health facilities in different units and also at a policy implementation level at the municipal health directorate as the PMTCT/ HIV, pregnancy school and health promotion coordinator in the La-Nkwantanang Madina Municipal Health Directorate in Accra, Ghana.

So I have been working with women at different stages of their health in materially under-resourced facilities in Ghana. Working in materially under-resourced health facilities in Ghana, I have witnessed firsthand, the devastating effect of poverty in women’s health. Poverty, race and gender affect the ways in which particular groups of women are constructed and treated in the healthcare sector.  Generally, however, women’s knowledge and experiences of and with maternity and child-care in Sub-Saharan Africa are usually discounted in the face of western biomedical practices and knowledge. As a practicing nurse, I have been struck and dismayed at the lack of acknowledgement or recognition of women’s own knowledge with regards to maternity and childcare but such knowledge, in the context of Ghana is considered ‘traditional and backward’.I have been particularly interested in understanding how gendered and racialized constructions of women and particularly rural and poor women, impact the quality of their interaction with healthcare personnel and probably the type of treatment they receive. So these questions, I felt would be better answered through research. There is an impact to be made on the health of these women by giving them a voice because working with them, one thing I’ve noticed is that they actually don’t have a voice in their own health.

So you’re doing your PhD right now?

Yes, I’m in my second year in the health equity stream. I am currently looking at the perception of reproductive health access for rural Ghanian women. My mentor and supervisor is Dr. Suzanne H. Campbell. Her work centers around transformational leadership in simulation and lactation, and she also happens to be a member of the Women’s Health Research Cluster here in UBC. She introduced me to this cluster and the lactation lab, which have both enhanced my research. I think there’s a lot that we can do for women if we try to solve health problems with evidence from research. We can make a lot of positive changes on what is impacting women’s health.

How would you explain your research in simple terms?

My area of research has to do with rural women who are at an age when they might be starting a family. During these ages, these women have the ability to decide when and how they choose to go to the hospital for services to help them achieve this goal. Sometimes, the society they live in makes it difficult for them to make this important decision. They may even have the money to go to the hospital for the services, but there might be pressure from their community that might change this decision. So in my research, I want to know about this moment when they want to access these services. I want to know about the possible challenges that they are facing in getting these services concerning childbirth and their well-being. Therefore, the purpose of this research is to contribute to finding solutions to problems that women face when going to the hospital for services that can help them choose when and if they want to have children. This will help make the rural women healthier and happier.

What makes you excited about the future of women’s health research? 

What makes me excited is working with top researchers, including my supervisors, Dr. Suzanne H. Campbell and Dr. Alison Phinney who are both changing lives with the wonderful works that they are doing. They are both excellent role models and they are contributing significantly and  impacting health outcomes for women, their families and the larger society. There are also a number of excellent role models in the Women’s Health Research Cluster here at UBC who are making a very significant impact in changing policies and impacting health outcomes for women. As the years go by, more research is being conducted and sponsored for women’s health and that tells us the future is promising for women’s health. Clusters such as the women health research institute here in UBC is training and mentoring more researchers in women’s health and that is one of the many steps that the cluster has taken in ensuring that issues of women’s health are made known to the rest of the world and that something is done about it. There are also a number of good grants that specifically sponsor research for women’s health and that shows that other stakeholders in health are coming to the negotiating table on women’s health. In the end, there will be enough evidence from these researches to change or amend or implement policies that will improve upon the health of women globally. There’s a light at the end of the tunnel and it is so exciting; for instance, in my case, I came to Canada (UBC) from Ghana and I am working in partnership with other health stakeholders so that I could make an impact back home in Ghana. I feel excited because I think we are making progress and I am happy to be a part of this progress in health research.

Looking back on your journey, are there things you wish you would have known when you were just starting as a women’s health researcher?

Yes! From my own experience, people to mentor you is very important. Also, getting involved in organizations like the Women’s Health Cluster are all helpful ways of staying tuned and abreast with issues around us. When I actually started my academic career, I was always more interested in the practical side rather than the other aspects, that is, teaching, administration and research. But then, as I became more grounded in the principles and theories behind my practice that I love so much, I realized that without research, the practice setting would not be improved and we cannot explain or substantiate what we do in the practical field. Research may look tedious, but that is actually how we find solutions to bigger problems. I would encourage anyone who has the love for research to go for it and never look back.

Any last thoughts that you would like to leave us with?

Women are the bedrock of society. Because of this, the health of women is actually the health of society and more attention should be paid on issues of women’s health. 

 

Behind the Frontlines for World Health Day

Author: Alex Lukey, Women’s Health Blog Co-Coordinator | Editors: Arrthy Thayaparan, Women’s Health Blog Co-Coordinator

Published: April 7th, 2021

This past year will go down in history as the year the world halted at the hands of a global pandemic. But the sacrifice and dedication from our frontline workers, kept hopes up and fears at bay throughout these unprecedented times. For World Health Day, our blog co-coordinator Alex Lukey sat down with two nurses, Krista Koenig and Lauren Dyck, working on the frontlines of COVID-19 hospital floors to talk about the past year.

The Beginning

Alex: Take me back to this time last year. What were those first few months like for you?

Krista: The first few weeks were kind of chaos. Nobody was sleeping well. We were all on edge, trying to figure out what was going to happen.

Lauren: I remember thinking to myself, I’ve only been out of school for two years. How do I deal with this? Even the people supporting us didn’t know what to do, so it was very confusing and scary.

Lauren: Every time we discharged a patient, another one would come through the door. It’s kind of what it is like right now actually too. Last spring, we were never over capacity, but we are now. We’ve got a couple of variants on my unit, and now it’s younger people coming in. Really, really sick people, so it’s a lot to deal with for sure. We’re all so burnt out trying to deal with the workload and then trying to deal with the deaths on top of it too.

The Hardest Part

Krista: I’ve never had trouble sleeping before this. That’s kind of where it translated for me. I didn’t see my family. I was just so scared of bringing it to somebody that I loved. Even though my family all lives here in town, I couldn’t see them.

Lauren: The mental health aspect of not for myself but for the patients. A lot of them, when they come to the hospital and are that sick, they’re here for a good three weeks.

Both Lauren and Krista spoke about the difficulty of supporting patients near the end of their lives. While many of the sickest COVID-19 patients are cared for in the intensive care unit (ICU), many long-term care home residents do not go to the ICU. These older adults may choose to forgo life-saving measures such as intubation. So, while nurses in the ICU dealt with many deaths from COVID-19, the brunt of deaths from long-term care homes fell on the shoulders of nurses working on lower acuity COVID-19 units, such as Lauren and Krista.

Lauren: There’s a lot of struggling at the end because you can’t breathe.  At the beginning, we weren’t even allowed visitors for people who were dying, so we’d have to zoom with their families. We would have to help them say goodbye like that which is just horrible. Now we do visits for some people, but some families are scared to come in, which I understand. But you can’t fix that emotional part of it. It’s hard to feel like you can’t really do anything about it.

Krista: Family members haven’t been able to visit unless somebody is critically ill or near death. I think that’s been one of the most significant changes for me too. In my practice, it’s so much centered around family care and including everybody.

Who is Caring?

Despite personal protective equipment (PPE), nurses are at a high risk of contracting the virus on the job. A report published by BC Women’s Foundation found that 80% of people working in healthcare are women in BC. Further, the roles with the highest risk of exposure due to close physical contact are professions that have higher numbers of women, such as nurses and personal care aides.

Krista: We did have nurses end up testing positive on our floors.  We were nursing our own nurses.

COVID-19 also presented women starting families with a difficult decision. While there is much more research needed, there was almost no information on the risks of COVID-19 for pregnant women a year ago. This lack of data continues to be a cause of significant concern for women.

Krista: We have so many pregnant nurses that we were trying to protect. We have such a strong solid group that we just try to look out for each other. We tried to give the positive patients to younger healthy nurses.

Hope

Both Krista and Lauren spoke about how access to the vaccine is giving them hope for the future.

Krista: It’s a big moment for science and history for everyone. Unfortunately, there’s still so much fear and miscommunication in this information and media right now about vaccines, but for our group that was such a turning point.

Lauren: When I got vaccinated, it was a very emotional moment for me. I actually almost cried because I was thinking, we’re gonna get through this. It’s almost like a race right now with our numbers going up and trying to vaccinate as many people as possible.

 

 

Meet the Nurses

Krista Koenig

Cardiac Medical RN

Asthmatic Frontline Worker

Vaccinated

 

 

Lauren Dyck

Lauren grew up in Vernon, BC, and completed her nursing degree at UBCO in Kelowna in 2018. After graduating, she moved to Vancouver and has since been working at Richmond Hospital on a cardiac/covid-19 ward. She will be starting a new job in May on the cardiac unit at Vancouver General Hospital. She hopes to pursue travel/ER nursing in the future.