Howard, Lisa

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    "Talking the walk to walk the talk": a qualitative report of patients' experiences of undergraduate nursing students using motivational interviewing
    (Sciedu Press, 2018) Howard, Lisa
    Background and objective: Motivational interviewing (MI) is a communication style adopted by health professionals to support patient-centered decision making about behavior change. Little is known about how patients respond to this relational approach when it is used by baccalaureate students. Thus, the study aim was to explore how patients experience MI by undergraduate nursing students when it is used to support health behavior change for vascular risk reduction. Methods: A focused ethnography was undertaken to explore the tacit and explicit dimensions of patient health behavior change as it evolved through MI encounters with nursing students. The research setting was a post-secondary institution in Canada and comprised a sample of 16 patients who received MI by the nursing students, 2 clinical instructors who teach MI, and 20 third-year nursing students who used MI as part of a 13-week community based clinical experience. Data sources included participant observations, field notes and one-to-one interviews. Results: Patients described their encounters with nursing students using MI as novel, relative to typical instances with health providers, and foundational to supporting lifestyle change. The patients’ overall experience is characterized by a thematic arc of ‘talking the walk to walk the talk’. Motivational interviewing helped patients integrate personalized information about the meaning of vascular health, deliberate on options and initiate lifestyle changes to promote health. In most cases, patients translated knowledge and experience from their motivational encounters with nursing students into subsequent health management activities. Conclusions: Through their experiences of nursing students using MI, patients understood the personal implications of vascular health, took action on relevant goals and applied lessons learned to future behavior change efforts. The results contribute new information about how patients respond to MI from baccalaureate nursing students and reinforce current understanding of how change talk contributes to subsequent change behavior.
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    DIGEST: a collaborative strategy for clinical performance feedback
    (Elsevier, 2018) Howard, Lisa; Will, Brielle
    The acronym DIGEST (discuss, invite, generate, explore, strategize, time) integrates motivational interviewing (MI) spirit, skill, and style to guide the student and instructor through discussions about clinical performance. This article aligns salient qualities of feedback and self-reflection in a relational approach to formative evaluation that is guided by MI. DIGEST is a strategy to promote self-reflection, provide clarity on areas for performance enhancement, and develop student capacity to integrate insights into subsequent practice.
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    Sexual expression in Alberta's continuing care homes: perspectives from managers and leaders
    (University of Lethbridge, 2018) Brassolotto, Julia; Howard, Lisa
    In this report, we outline the findings from Phase 1 of a multi-phase, Alberta-wide study on sexual expression in supportive living and long-term care homes. In what follows, we outline some of the key themes from the academic literature; briefly describe our methods for data collection and analysis; share key findings; and make recommendations for practice, policy, research, and education. We conclude with a list of resources for those navigating sexual expression in continuing care.
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    Sexual expression in Alberta's continuing care homes: perspectives from residents and family members
    (University of Lethbridge, 2019) Brassolotto, Julia; Howard, Lisa
    In this report, we outline the findings from Phase 2 of a multi-phase, Alberta-wide study on sexual expression in supportive living and long-term care homes. By “sexual expression,” we mean handholding, hugging, fantasizing, bed sharing, kissing, masturbation, grooming and self-presentation, forming intimate relationships, and engaging in physical sex acts. In what follows, we outline some of the key themes from the academic literature; briefly describe our methods for data collection and analysis; share key findings; and make recommendations for policy and practice. We conclude with a list of resources for family members and residents who are navigating sexual expression in continuing care homes.