A5007756606- Family and Patient Care in Intensive Care Units
- Infant Development and Preterm Care
- Childhood Cancer Survivors' Quality of Life
- Child and Adolescent Health
- Child Nutrition and Feeding Issues
- Family and Disability Support Research
- Sleep and related disorders
- Tracheal and airway disorders
- Congenital Diaphragmatic Hernia Studies
- Respiratory Support and Mechanisms
- Neonatal Respiratory Health Research
- Neuroscience of respiration and sleep
- Healthcare Policy and Management
- Adolescent and Pediatric Healthcare
- Airway Management and Intubation Techniques
- Family Support in Illness
- Phonocardiography and Auscultation Techniques
- Palliative Care and End-of-Life Issues
- Literature Analysis and Criticism
- Primary Care and Health Outcomes
- School Health and Nursing Education
- Dysphagia Assessment and Management
- Interprofessional Education and Collaboration
- Child Nutrition and Water Access
- Pediatric Pain Management Techniques
Hospital for Sick Children
2014-2024
University of Toronto
2013-2024
Institute for Clinical Evaluative Sciences
2024
SickKids Foundation
2007-2023
Great Ormond Street Hospital
2021-2022
University College London
2021-2022
Holland Bloorview Kids Rehabilitation Hospital
2011-2018
Bloomberg (United States)
2015
Home and Community Care Support Services
2011
Over the last 30 to 40 years, improvements in technology, as well changing clinical practice regarding appropriateness of long-term ventilation patients with "non-curable" disorders, have resulted increasing numbers children surviving what were previously considered fatal conditions. This has come but at expense requiring ongoing, prolonged mechanical (both invasive and noninvasive). Although there are many publications pertaining specific aspects home (HMV) children, few comprehensive...
<h3>Objectives</h3> To determine: (a) prevalence of clinically unsuspected nocturnal hypoventilation (NH) in a clinic population children with progressive neuromuscular disease; (b) whether NH can be predicted from clinical/laboratory parameters; and (c) change over 1 year pulmonary function decline, quality life attention treated non-invasive positive pressure ventilation (NPPV) compared without NH. <h3>Design</h3> Prospective cohort study. <h3>Setting</h3> Two tertiary-care paediatric...
Family caregivers of children who depend on medical technology (CMT) provide highly skilled care up to 24 hours per day. Sleep disruption places family at risk for poor health and related outcomes that threaten their long-term caregiving capacity. Few studies exist have measured sleep in caregivers, most relied entirely subjective measures.In a prospective cohort study, CMT (n=42) healthy (n=43) were recruited. Actigraphy data concurrent diary collected 6 days/7 nights. Measures quality,...
Abstract This study evaluated a dyadic peer support pilot intervention for parents of technology-assisted children with chronic lung disease. These medically-fragile children, living at home in the primary care their parents, require continuous or intermittent assistance from technological such as oxygen, respiratory cardiac monitors and/or mechanical ventilators. The consisted matching similar caregiving responsibilities, order to reciprocally engage parent-to-parent support. Results...
This qualitative descriptive study explores the experiences of family caregivers (FCs) children with medical complexity who are initiated on new technology in hospital and transition to daily life at home. The aims investigate FCs' response readiness for use, value education support challenges associated managing home.A approach was used conduct analyse 14 semistructured interviews a group FCs composed 11 mothers 3 fathers. Content analysis transcripts caregiver interviews. conducted...
Abstract Background Integrated care has important implications for children with medical complexity ( CMC ) who rely on and service delivery involving multiple providers in different places over time. Most studies describing complex programmes focus the effectiveness of co‐ordination rather than process system integration. This pilot study explores implementation I ntegrated C omplex are M odel: a voluntary partnership between acute, rehabilitative community aimed at integration through key...
Providing integrated care for children with medical complexity in Canada is challenging as these are, by definition, need of coordinated from disparate providers, organizations and funders across the continuum order to optimize health outcomes.We describe development an inter-organizational team constructed a unique tripartite partnership acute hospital, children's rehabilitation hospital home/community organization focused on who frequently use services three organizations.Model building...
Objective Health related quality of life (HRQL) children using medical technology at home is largely unknown. Our aim was to examine the HRQL in on long-term ventilation (LTHV) comparison a cohort an enterostomy tube. Study Design Participants were divided into three groups: 1) LTHV without tube (LTHV cohort); 2) Enterostomy (GT 3) with (LTHV+GT cohort). Caregivers ≥ 5 years and followed SickKids, Toronto, Canada, completed questionnaires: Utilities Index 2/3 (HUI2/3), Caregiver Priorities...
Respite for families of children and youth with special healthcare needs (CYSHCN) is essential sustaining a family care environment. Lacking an understanding families' respite experiences who reside in Canada. We sought to understand the use services by CYSHCN aim help improve services. This paper reports on qualitative arts-based findings. Qualitative methods including open-ended interviews combined ecomaps photovoice process were used. Analysis involved delineating units meaning from data,...
Increasingly, children with respiratory conditions who are dependent on medical technology (e.g. ventilators and tracheostomies) cared for at home by family caregivers risk significant health, financial social burdens. In many jurisdictions, access to quality respite is varied often the availability of regulated (nursing) providers insufficient. Rather than go without, some families have secured alternative unregulated supplement formal care systems. The purpose this study was explore...
Policy to support informal caregivers is a critical health policy issue in Canada. Lessons may be learned from the perspectives and experience child field with applicability for all cared-for persons their caregivers. Familycentred care addresses centrality of family caregiver design delivery services. A life course approach focuses on key periods transition downstream effects facing over lifetime. The medical home model where more coordinated offers potential direct cost savings both...
Abstract Objectives Discharging a child home on long‐term ventilation (LTV) via tracheostomy is complex and involves multiple healthcare providers across sectors. To date, there has been paucity of data with respect to the experiences families transitioning LTV. Our objective was explore perceptions family caregivers (FCs) who have completed newly developed LTV discharge pathway as they transitioned home. Methods We conducted 11 semi‐structured interviews FCs. Interviews focused FC's...
This article is related to:Pediatric home mechanical ventilation: A Canadian Thoracic Society clinical practice guideline executive summary
This article is related to:Pediatric home mechanical ventilation: A Canadian Thoracic Society clinical practice guideline executive summary
Pediatric nursing expertise in home care requires continuous development and maintenance of competencies. Through the pandemic, practice essential "hands-on" skills was enabled by delivery training mannequins from hospital to a shift virtual education. Learners (n = 57) included family caregivers children with medical complexity nurses new care. Evaluation informed iterative design service signalled "Connected Care on Go!" as desirable (100% highly satisfied), feasible easily implemented)...
Objective To evaluate the immediate and sustained knowledge retention sense of self-efficacy homecare nurses following completion a standardized competency-based tracheostomy education course. Safe discharge children requiring with or without ventilation relies on competence nurses. Study Design Pragmatic, randomized controlled trial 44 Participants were into intervention group ( n = 21), which received course, control 23), an enterostomy vascular access Multiple-choice question (MCQ)...
Abstract Background Homecare nursing is considered essential to the care for children with medical complexity (CMC) given their intense daily demands and dependence on technology. While patients, families, healthcare providers (i.e., paediatricians, nurse practitioners) rely homecare nurses (HCNs), there limited research exploring factors that either promote or challenge ability of HCNs provide safe satisfactory in home environment. Objectives This study aims gain a thorough understanding...
Family caregivers of children with complex care needs that depend on medical technology (e.g. home ventilation) are relied upon to provide skillful, vigilant homecare 24-hours/day. This responsibility has been linked chronic sleep disturbance, placing family at risk poor health outcomes. To inform testing a promoting intervention, the following questions have guided this research: What factors influence among caregivers? How do appraise utility sleep-promoting interventions? what degree...