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- ItemChildbearing Cambodian Refugee Women(The Canadian Nurse, 1988) Kulig, Judith CeleneThe goal of this study was to discover cultural knowledge held by Cambodian refugee women in regard to conception and fetal development and how this might relate to birth control use and prenatal care. Maternal-child issues are important due to the higher than average birth rate in this population.
- ItemCommunity Assessment of the Kanadier (Mexican) Mennonites: Final Report(Regional Centre for Health Promotion and Community Studies, University of Lethbridge, 1995) Kulig, Judith Celene; University of Lethbridge. Regional Centre for Health PromotionA needs assessment was completed with the target group, the Kanadier Mennonites. This assessment was successfully completed through a partnership between the School of Nursing, University of Lethbridge Advanced Community Nursing class, the Barons- Eureka-Warner (BEW) Health Unit (now part of the Chinook Regional Health Authority) and the Mennonite Central Committee local office, the Kanadier Concerns. Thirteen student teams conducted interviews with 22 key informants and 44 household informants. Male and female interpreters, fluent in English and Low German, were used as translators and cultural interpreters. The limitations include the inability to randomize the sample, the need to use interpreters which may have led to a loss in understanding, the misinterpretation by the student teams of some of the questions, or the in accurate completion of the demographic information sheets by some of the student teams.
- ItemThe concepts of resiliency: Theoretical lessons from community research(Health and Canadian Society, 1996) Brown, David D.; Kulig, Judith CeleneResiliency is a concept for which both its appeal and frustration comes from the elasticity of its meaning. The idea of resiliency commonly has been found in areas of human development and psychopathology, there is now an increased interest in extending its application. Community resiliency is increasingly a central element in public health policies and programs. In what follows, we strive to identify some central theoretical issues that arise when the concept of resiliency is applied to communities. Our purpose is to work through these issues in a way that clarifies the concept by bringing together useful, though otherwise disparate, strands from the research literature.
- ItemHealth care for the Mexican Mennonites in Canada(The Canadian Nurse, 1998) McCaslin, C.; Kulig, Judith CeleneThe basic story of Canadian Mennonites is well known: During the centuries since the founding of the Mennonite church in Holland in the 1500s, religious persecution has led to group migration throughout Europe and to North America. Mennonites who came to Canada settled mainly in southern Ontario and the western provinces, where they maintained their religious practices, language, education and agrarian lifestyle. Less well known is that, in the 1920s, when the Canadian government mandated that all schools must use the provincial school curricula, some conservative Mennonites chose to leave Canada for Mexico, where they had been promised religious and educational freedom.
- ItemChildbearing practices in Kanadier Mennonite Women(The Canadian Nurse, 2004) Kulig, Judith Celene; Hall, Barry; Babcock, Ruth C. A.; Campbell, Robert; Wall, MargaretCross-cultural nursing practices call for attention to be paid to the unique beliefs and practices of the groups with which nurses come in contact. The Kanadier Mennonites are a conservative religious group who live in Alberta, Manitoba and Ontario. An exploratory, descriptive study was conducted with this group in southern Alberta to generate information about their health and illness beliefs. This article focuses on their knowledge, beliefs and practices in relation to childbearing interviews were conducted with 45 women, the majority of whom were married and had been born in Mexico. Among the sample there had been a range of one to 16 pregnancies. The participants noted that childbearing Is not a topic openly discussed with others. Women learn about childbearing from their mothers and other women but also from physicians and books. During pregnancy there are particular activities to be avoided including the use of strong cleaning fluids and hand milking of cows. Foods such as milk need to be ingested to ensure a healthy pregnancy. Prenatal care was not emphasized in Mexico nor has it become a customary practice in Canada but deliveries in hospital are the norm in both these countries. During the postpartum the women receive support from their immediate and extended family in order to recuperate. Nurses need to explore individual Kanadier Mennonite beliefs regarding childbearing and work with this group in developing acceptable health promotion programs to help ensure healthy pregnancy outcomes. The blending of nursing practice knowledge in a non-intrusive manner with a group of people with differing belief systems is a necessary and achievable goal.
- ItemCapacity building in rural research: A Canadian perspective(Rural and Remote Health, 2004) Kulig, Judith Celene; Minroe, Bruce; Stewart, NormaIntroduction: The need to build capacity in rural health research is recognized in Canada. During its formative stage, the Canadian Rural Health Research Society (established in 2002), performed a nation-wide survey of the research teaching and training opportunities available to students interested in rural and remote health issues. Intended as a cross-sectional ‘snapshot,’ and to provide base-line data, the survey involved a comprehensive list of educational programs in health and science disciplines at all Canadian Universities offering graduate-level programs. The present project report gives an overview of the results, documenting the current strengths, but also the noticeable gaps that exist. Methods: Data were collected via an Internet survey, developed according to Dillman’s email survey design principles. Although multiple contacts are recommended, due to time constraints only two were made. The instrument included both open- and closed-ended questions designed to determine institutional commitments to rural health research training generally, as well as specific information about course offerings, infrastructure supports for students, financial assistance for studying specific topics, and future plans. Health was defined broadly and included a number of disciplines beyond those usually considered under the health rubric. Individuals in administrative positions for 462 programs in 24 distinct disciplines at 56 institutions were sent the survey. Responses were received from 120 programs at 40 universities. Due to budget constraints the instrument was not translated into French. Descriptive statistics were used to analyse the data, combined with a thematic analysis of written comments. Ethical approval was obtained from the Lakehead University before the study was conducted. Results: Despite the fact that one-third of Canadians live in rural, remote and northern areas, there is a paucity of research that addresses rural health issues. Moreover, Canadian universities have very limited rural health offerings in their curricula. There are few formal courses available on rural health topics generally or rural health research specifically. Although students can take rural-related independent studies or reading courses, very few actually take advantage of the option. Of all disciplines, nursing faculty are most likely to pursue rural health research and to offer rural health courses. Moreover, nursing faculty most often indicate an intention to expand their rural health offerings. In the social sciences, geography and environmental science programs, relatively few students choose to study rural health. Similarly, in medicine, the number of students exploring rural health issues is small. There is some specific financial assistance available to students who are interested in rural health research and, as well, they have access to general pools of funding. Conclusion: The survey results demonstrate the limitations of current educational programs. However, they also indicate areas of potential growth and show widespread interest in increasing the offerings available at universities across Canada. The article concludes by giving an overview of the mandate and initiatives being taken by the new research society to augment training, and to enhance student participation. In addition, it notes the positive developments linked to a new Strategic Plan by the Canadian Institutes of Health Research (CIHR) to enhance rural health research in Canada.
- ItemThe nature of nursing practice in rural and remote Canada(The Canadian Nurse, 2004-06) Macleod, M.; Stewart, Norma; Pitblado, Roger; Knock, M.; Kulig, Judith CeleneThese approaches complement one another while adding to our overall understanding of rural nursing practice. For example, the RNDB had not previously been analysed with rural nurses in mind. The demographic profile of rural RNs was generated for the first time for Canada as a whole and for the individual provinces and territories.(18) The documentary analysis takes a critical view of the policy context within which rural nurses practise.(19) The national survey has collected an abundance of information about rural nurses' work, quality of work life and degree of work satisfaction. And the experiences that nurses relate in the narrative approach bring to life the challenges and rewards of working in a variety of rural settings. A national survey of RNs working in rural and remote areas has been completed using a mailed questionnaire and followup based on Dillman's tailored design method.(29) The 3,933 eligible respondents represent all provinces and territories and an overall response rate of 68 per cent after correcting for duplicate registrations, address problems, and ineligibility (e.g., living rural, working urban). Sampling was done in collaboration with the professional nursing associations of each province and territory, using the databases of all RNs with active registration, while maintaining anonymity and confidentiality. The sampling strategy was twofold. First, a stratified random sample was selected from RNs with rural addresses(30) in each of the 10 provinces. Second, the questionnaire was mailed to the total population of Canadian RNs who indicated on their registration forms that their primary workplace was a nursing station or outpost setting and to all RNs registered in the territories (as an attempt to capture "remote" areas). Based on a total population of 229,813 RNs in Canada,(31) with stratification by province and assuming that the ratio of rural/urban nurses was similar to the rural/urban population proportions in the provinces,(32) we determined that 3,500 rural nurses would provide estimates that are statistically significant (p <.05) nationally, with a 90 per cent confidence level provincially. Rural nurses have many reasons to celebrate: they provide care to individuals and families of all ages, for a variety of conditions, in a range of rural and remote settings. Although they work in environments that are primarily governed by urban-centric policies and in workplaces where the quality of work life is often limited, the nurses reveal their passion and dedication to their communities and to practising in rural and remote areas through their stories and their survey comments. The nature of rural and remote nursing is deceiving; its complexity is seen during the nurses' interactions, first as community members and then as professionals. Rural nurses are often charting new courses in their communities and workplaces. Muriel Strode said, "Do not follow where the path may lead. Go instead where there is no path and leave a trail."(33) Discovering the nature of nursing practice in rural and remote Canada through this national study is the first step on such a path, and hopefully the first of many trails.
- ItemAboriginal nurses: Insights from a national study(The Canadian Nurse, 2006) Kulig, Judith Celene; Stewart, Norma; Morgan, Debra; Andrews, Mary Ellen; MacLeod, Martha; Pitblado, Roger;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.
- ItemViolence in rural communities: Youth speak out(Rural and Remote Health, 2006) Kulig, Judith Celene; Hall, Barry; Grant Kalischuk, RuthIntroduction: The current available literature does not present the viewpoints of rural youths regarding the meaning of violence. Design: A mixed method exploratory, descriptive study was conducted to generate information from rural youth about violence. The qualitative phase of the exploratory, descriptive study is reported here. Results: Interviews with fifty-two youth (20 males and 32 females), ranging in age from 11 to 19 years in grades 7–12 in the public school system were conducted in two rural communities. The participants initially defined violence as a physical act with intent to harm, but did not consider weapon carrying as an issue in their communities. They identified alcohol consumption as a trigger for violence and described planned fights that occurred away from school grounds. Physical fights were not limited to the male students. The youth openly stated that violence exists in rural communities and felt isolated from adults with regard to understanding the youths’ experiences with violence. Conclusion: It is important to generate information about violence directly from rural youth. Programs to reduce violence that include the youth are important to pursue.
- ItemThe development of the Canadian rural health research society: Creating capacity through connections(Rural and Remote Health Online, 2007) Macleod, Martha; Dosman, J.; Kulig, Judith Celene; Medves, JenniferContext: The organization of rural health research in Canada has been a recent development. Over the past 8 years, rural and remote researchers from more than 15 universities and agencies across Canada have engaged in a process of research capacity building through the development of a network, the Canadian Rural Health Research Society (CRHRS) among the scientifically and geographically diverse researchers and their community partners. The purpose of this article is to discuss the development of the CRHRS as well as the challenges and lessons learned about creating networks and building capacity among rural and remote health researchers. Issue: Key elements of network development have included identifying and developing multidisciplinary research groupings, maintaining ongoing connections among researchers, and promoting the sharing of expertise and resources for research training. The focus has been on supporting research excellence among networks of researchers in smaller centres. Activities include a national annual scientific meeting, the informal formation of several regional and national research networks in specific areas, and the development of training opportunities. Challenges have included the issues of sustaining communication, addressing a range of networking and capacity-enhancement needs, cooperating in an environment that rewards competition, obtaining resources to support a secretariat and research activities, and balancing the demands to foster research excellence with the needs to create infrastructure and advocate for adequate research funding. Lessons learned: The CRHRS has learned how to begin to support researchers with diverse interests and needs across sectors and wide geographical areas, specifically by: (1) focusing on research development through creating and supporting trusting connections among researchers; (2) building the science first, followed by infrastructure development; (3) making individual researchers the nodes in the network; (4) being inclusive by accommodating a wide variety of researchers and researcher strengths; (5) emphasizing social exchange, knowledge exchange, and mentoring in annual scientific meetings; (6) taking opportunities to develop separate projects while finding ways to link them; (7) finding a balance between advancing the science and advocating for adequate funding and appropriate peer review; (8) developing a network organizational structure that is both stable and flexible; and (9) maintaining sustained visionary leadership.
- ItemUnderstanding Community Resiliency in Rural Communities through Multimethod Research(Journal of Rural and Community Development, 2008) Kulig, Judith Celene; Edge, Dana; Joyce, BrendaCommunity resiliency is a theoretical framework and social process that attempts to explain how communities address adversity. Generating information about this concept has largely been accomplished through qualitative research methods and the development of the Resiliency Scale, which was based upon previous qualitative research on the topic. A multimethod study was used to explore community resiliency in two rural communities and one urban neighborhood. In this article we specifically examine: “What are the merits of employing different research methods to explore community resiliency and health status?” Qualitative interviews, a household survey, and analysis of provincial health databases were all used. The understanding of community resiliency as identified from each of these three methods as well as a discussion of the advantages and disadvantages of each method is presented.
- ItemBullying perspectives among rural youth: A mixed methods approach(Rural and Remote Health Online, 2008) Kulig, Judith Celene; Hall, Barry; Grant Kalischuk, RuthIntroduction: Few studies have examined violence among rural youth even though it is recognized as a societal concern. A mixed method, descriptive study was conducted to examine violence among rural youth including their perceptions and experiences of it. This article focuses specifically on the perceptions and experiences of bullying among rural youth that were generated from the Qualitative Phase One interviews and Quantitative Phase Two responses. Method: A mixed method study was conducted in two separate phases. The information generated from the Qualitative Phase One (n = 52) was used to develop a survey instrument employed in the subsequent Quantitative Phase Two (n = 180). The youth who were involved in each phase lived in different geographic areas of a Western Canadian province. The qualitative phase generated a number of comments about the experience of being bullied or how it felt to be a bully. In the survey instrument, specific questions related to bullying were embedded within it. Demographic information was collected in both phases of the study. Research assistants were used to collect the data in each phase. The transcripts from the qualitative phase were analyzed for categories and themes. The survey instrument included demographic questions and seventy questions that included a four-point Likert scale. The data were analyzed using SPSS v14 (SPSS Inc; Chicago, IL, USA). For this article, the survey questions that focused on bullying were considered alongside the qualitative comments in order to more fully understand the perceptions and viewpoints of rural youth regarding this particular aspect of violence. Results: Conducting a mixed method study provides a more in-depth understanding of bullying among youth in the rural context. The pain and humiliation of being bullied provided a personalized understanding of the survey responses that indicated which youth are targets of bullying. For example, comments were made about being picked on because of personal characteristics such as being overweight or dressing in an unacceptable manner. In addition, bullies openly talked about the power they gained from their role. The frequency responses to the questions in the survey confirmed that bullies obtain power from their behavior and that youth who are different are bullied. The participants also noted that something needed to be done to address bullying but remarked that they would not seek professionals’ help. Discussion: The findings negate the myth that rural places are ideal places to raise children. Although the youth did not identify that they would access professionals, it is important for members of rural communities to acknowledge bullying, its impacts and how they can prevent it. Working from the social structure of rural communities is a first step in this process. Conclusion: Rural communities will benefit as a whole if bullying, an important societal concern, is addressed. Building on the social structure of rural communities is important, However, listening to rural youth themselves is the key if true change is to be implemented.
- ItemBeing a woman: Perspectives of Low German-Speaking Mennonite women(Health Care for Women International, 2009) Kulig, Judith Celene; Babcock, Ruth C. A.; Wall, Margaret; Hill, S.Understanding the beliefs and knowledge related to women’s sexuality is important when working with unique religious groups in order to provide culturally appropriate care. An exploratory, descriptive qualitative study generated knowledge, beliefs and practices related to menstruation, ovulation and family planning among Low German-speaking Mennonite women (n = 38). There is a pervasive silence that surrounds sexuality among this group with limited understanding of the physiological changes they experience. Honoring religious principles and family and community expectations through acceptable female behavior is essential. Adherence to religious principles varies by family but is not shared with the group to avoid disfavor.
- ItemWork setting, community attachment, and satisfaction among rural and remote registered nurses(Public Health Nursing, 2009) Kulig, Judith Celene; Stewart, Norma; Penz, K.; Forbes, D.; Morgan, D.; Emerson, P.Objective: To describe community satisfaction and attachment among rural and remote registered nurses (RNs) in Canada. Design and Sample: Cross-sectional survey of rural and remote RNs in Canada as part of a multi-method study. The sample consisted of a stratified random sample of RNs living in rural areas of the western country and the total population of RNs who worked in three northern regional areas and those in outpost settings. A subset of 3,331 rural and remote RNs who mainly worked in acute care, long-term care, community health, home care, and primary care comprised the sample. Measures: The home community satisfaction scale measured community satisfaction, whereas single-item questions measured work community satisfaction and overall job satisfaction. Community variables were compared across practice areas using analysis of variance, whereas a thematic analysis was conducted of the open-ended questions. Results: Home care and community health RNs were significantly more satisfied with their work community than RNs from other practice areas. RNs who grew up in rural communities were more satisfied with their current home community. Four themes emerged from the open-ended responses that describe community satisfaction and community attachment. Conclusions: Recruitment and retention strategies need to include mechanisms that focus on community satisfaction, which will enhance job satisfaction.
- ItemLevels of risk: Perspectives of the Lost Creek fire(Australian Journal of Emergency Management, 2009) Kulig, Judith Celene; Edge, Dana; Reimer, William; Townshend, Ivan; Lightfoot, NancyRisk has been considered as the probability of experiencing adverse events. Understanding risk and vulnerability is essential to disaster management and recovery. Through qualitative interviews in a community that experienced a wildfire, ‘at-risk’ and ‘feeling at-risk’ themes were identified for both the individuals and community in this study. Internal and external circumstances along with varying levels of dependence influenced the reports of risk. Individual and community risk during a major wildfire is discussed in order to explain links to community resiliency. Such understandings can aid in the development of appropriate measures to reduce short- and long-term impacts from natural disasters.
- ItemReport of the household survey: Coaldale, AB(University of Lethbridge, 2010) Kulig, Judith Celene; Reimer, William; Townshend, Ivan; Edge, Dana; Lightfoot, Nancy; Kimmel, Ainslee; Hosgood, EmmaThere are mounting concerns about individual and community preparedness for disasters in part because disasters are increasing in numbers. Circumstances such as pine beetle infestations, climate change and an increased number of homes in forested areas contribute to the increased number of disasters and their impacts. In order to understand community response to wildfires, a mixed method study was conducted (2008-2010) in two communities in western Canada (Barriere, British Columbia and La Ronge, Saskatchewan) (ruralwildfire.ca). These two communities were selected since they had endured wildfires that resulted in community evacuation with significant loss of property (McClure fire in BC, 2003; and, Mallard fire in SK, in 1999). Coaldale, Alberta was chosen as a comparison community that had not experienced a recent natural disaster and was of similar size to Barriere and La Ronge.
- ItemAboriginal Science Symposium: Enabling Aboriginal student success in post-secondary institutions(Rural and Remote Health Online, 2010) Kulig, Judith Celene; Duke, Michelle; Solowoniuk, Jason; Weaselfat, Roy; Shade, Cam; Wojtowicz, Bernadine; Lamb, MarilynContext: Research in the sciences is now beginning to acknowledge what many Aboriginal educators and students have experienced or witnessed in educational curricula, a general dismissal of Indigenous knowledge as being considered scientifically ‘worthy’. This is the result of educational institutions’, and the systems within which they are placed, failure to teach from broad cultural orientations. Aboriginal persons are under-represented in post-secondary education programs, with a similar disparity in the limited number of Aboriginal persons holding careers in health, science and engineering occupations. Issues: The University of Lethbridge is attempting to increase the number of Aboriginal students who successfully complete programs in a variety of areas. To that end, the Support Program for Aboriginal Nursing Students (SPANS) commenced in Fall 2007 in order to increase the numbers of Aboriginal students who enter and complete the 4 year nursing program. At one time there were as few as 2–3 Aboriginal nursing students across the 4 years of the program. Since SPANS began there are now 34 students of Aboriginal background across all 4 years of the nursing program. This is noteworthy because statistically there are only 1200 Aboriginal Registered Nurses in Canada, a daunting statistic that is alarming low. One of the objectives of SPANS is to enhance the nursing faculty and clinical instructors’ understanding of Aboriginal science so that it can be integrated into the current curriculum. With this aim, an Aboriginal Science Symposium was held in May 2009 to bring nursing faculty together with other University faculty and experts in Aboriginal science. The symposium attempted to highlight the links between programs in nursing and health sciences and the need for integration with Aboriginal science. The 3 specific symposium objectives were to: (1) generate an understanding of traditional scientific knowledge; (2) bridge Aboriginal and Western scientific thought, toward and; (3) understand ways of implementing and raising awareness of how Aboriginal knowledge and understanding of science can be applied to help inform and improve teaching in all educational science settings. Lessons learned: From keynote addresses, panel group discussions, and breakout sessions, participant responses to the symposium objectives coalesced into 4 themes: (1) Aboriginal ways of knowing: informing Western science curricula; (2) Elders and community, enhancing science education; (3) Aboriginal student experience in the science classroom; and (4) strategies and advice to meet the needs of the Aboriginal science student.
- ItemReport of the household survey: La Ronge, SK(University of Lethbridge, 2010) Kulig, Judith Celene; Reimer, William; Townshend, Ivan; Edge, Dana; Lightfoot, Nancy; Kimmel, Ainslee; Hosgood, EmmaMounting concerns about individual and community preparedness for disasters are being voiced, in part because natural disasters are increasing. In Canada, circumstances such as pine beetle infestations, reduced precipitation coupled with above normal tem-peratures, and an increased number of homes in forested areas contribute to the in-creased occurrence of wildfires and their impact on humans. In order to understand community responses to wildfires, a mixed method study was conducted (2008-2010) in two communities in western Canada: Barriere, British Columbia and La Ronge, Sas-katchewan (ruralwildfire.ca). These two communities were selected since they had en-dured wildfires that resulted in community evacuation with significant loss of property (McClure fire in BC, 2003; and, Mallard fire in SK, 1999).
- ItemThe 1999 Mallard fire: Lessons learned(The Faculty of Health Sciences - The University of Lethbridge, 2010) Kulig, Judith Celene; Kimmel, A.; Gullacher, A.; Reimer, B.; Townshend, Ivan; Edge, Dana; Lightfoot, Nancy; McKay, M.; Barnett, M.; Clague, J.; Coghlan, A.La Ronge is located in northern Saskatchewan on the shore of Lac La Ronge. It is adjacent to the Lac La Ronge Indian band and the northern village of Air Ronge. La Ronge is the largest community in northern Saskatchewan with over 2700 people residing in the town, 2000 people on the adjacent First Nations lands of the Lac la Ronge Indian band, and approximately 1000 people residing in the bordering Métis settlement of Air Ronge. La Ronge acts as the service centre for almost all of Northern Saskatchewan. Firefighters battled the Mallard Fire that caused the evacuation of the entire community of La Ronge on May 27, 1999. The fire, which was started by lightning, stretched over a distance of 8 kilometres and it took one week, 248 firefighters, and several water bombers to extinguish it. The damage included the destruction of 8 homes in Eagle Point, 1 trailer on Riese Drive and 1 bush home. Some commer-cial buildings were also destroyed within the town boundaries; however, no injuries were reported.
- ItemCritical Ethnography, Cultural Safety, and International Nursing Research(International Journal of Qualitative Methods, 2010) Harrowing, Jean N.; Mill, Judy E.; Spiers, Jude; Kulig, Judith Celene; Kipp, WalterCritical qualitative methodology provides a strategy to examine the human experience and its relationship to power and truth. Cultural safety is a concept that has been applied to nursing education and practice and refers to interactions that acknowledge and respect the unique cultural background of patients. It recognizes power inequities between caregivers who belong to dominant cultures and patients who may belong to oppressed groups. Culture is interpreted from a critical constructivist perspective as a fluid relational process that is enacted contextually. The purpose of this paper is to examine the congruence between and among critical methodology, cultural safety, and the conduct of nursing research in low- and middle-income countries by nurses from high-income countries. It is argued that if cultural safety is important and relevant to education and practice, then it might be appropriate to address it in research endeavors.