Lindsay Curtis

U of T researchers investigate 'moral distress' among nurses during COVID-19

Christopher.Sorensen — Mon, 11 May 2020 17:48:58 +0000

U of T researchers investigate 'moral distress' among nurses during COVID-19

Christopher.Sorensen Mon, 05/11/2020 - 13:48

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"The stress of learning how to support a patient in the absence of their family, and of working in a situation that is rapidly evolving ... can cause distress and make nurses feel very helpless,” U of T alumna Donna Ruffo says (photo by Nick Iwanyshyn)

Lindsay Curtis

Topic

Our Community

Coronavirus

Alumni

Faculty & Staff

Lawrence S. Bloomberg Faculty of Nursing

Donna Ruffo typically works as a nurse practitioner on the geriatric medicine outreach team at North York General Hospital.

An alumna of the �ؿ�ζSM’s Lawrence S. Bloomberg Faculty of Nursing, Ruffo assesses, diagnoses and treats frail seniors – in collaboration with their referring family doctors or nurse practitioner – to help them get the health care they need and prevent unnecessary visits to the emergency room.

But when the COVID-19 pandemic arrived in Canada, Ruffo’s roles and responsibilities began to change as the hospital navigated the rapidly unfolding situation.

“We were no longer allowed to have in-home visits, so I began providing virtual care for patients and their families,” Ruffo says.

As the pandemic ramped up, the hospital reallocated resources in profound ways, closing elective surgeries and reorganizing spaces and teams in order to accommodate incoming COVID-19 patients.

Ruffo says she and other nurses suddenly found themselves innovating and leading in the midst of a crisis.

“Some of my responsibilities involved providing physical assessment for the nurses who were being redeployed, helping them gain confidence in learning new skills to be able to take care of critically ill patients,” says Ruffo.

While nurses have long played a key role in the delivery of health care under difficult conditions –the extraordinary demands placed on nurses by the1918 Spanish flu pandemic spurred Kathleen Russell, the founding director of U of T Nursing, to call for progressive reforms in nursing education in Canada – many are accustomed to working in a designated specialty area such as the operating room, day surgery or pediatric units.

“Not surprising, there was a lot of fear and doubt,” says Ruffo of nurses who were redeployed to help with COVID-19. “Nurses told me that they didn’t necessarily feel confident to work with acutely ill patients. I reminded them that they are nurses who have exceptional critical thinking skills, effective communication and compassion which are transferable across settings – they’ve got what it takes to do what’s being asked of them.”

Even so, nurses across Canada are struggling with fears surrounding the impact of COVID-19 on themselves, their families, their patients, caregivers and the health-care system at large, which can result in feelings of helplessness and distress.

“Nurses are used to high-demand, fast-paced days,” says Ruffo. “[But] the stress of learning how to support a patient in the absence of their family, and of working in a situation that is rapidly evolving and has so many unknowns, that can cause distress and make nurses feel very helpless.”

Elizabeth Peter, a professor at U of T’s Lawrence S. Bloomberg Faculty of Nursing, which is celebrating its centenary this year, is exploring the emerging moral challenges that nurses are experiencing during the pandemic. Her research is being supported by the �ؿ�ζSM COVID-19 Action Fund.

Peter and her team – Shan Mohammed, an assistant professor, teaching stream, Jane MacIver of the Ted Rogers Centre for Heart Research, and PhD student Tieghan Killackey – will recruit and interview 40 nurses who have been caring for patients with COVID-19 to learn about their experiences.

“In nursing, there is significant literature on moral distress, but very little is known on what prevents it or makes people feel better,” Peter says.

The ultimate goal is to develop strategies to help nurses through the moral distress caused by working through the pandemic. Since early support is key for addressing trauma from moral distress, Peter and team plan to disseminate their findings as early as August.

“Once we’ve conducted the interviews, we plan to immediately assemble specific guidelines and recommendations related to alleviating moral distress, and broadly disseminate findings to health-care settings locally and internationally,” she says, adding that the work may help inform the health-care system’s responses to future crises.

As for Ruffo, she spends time each day checking in with nurses throughout the hospital to ask how they’re coping. While some express feelings of stress, worry and fatigue, Ruffo takes comfort in knowing she and her colleagues will band together to get through the crisis.

“In the 21 years I’ve worked at NYGH,” she says, “we’ve always come together in the most critical times to get through.”

Data sharing by popular medical apps is 'routine,' U of T researcher finds

noreen.rasbach — Tue, 26 Mar 2019 04:00:00 +0000

Data sharing by popular medical apps is 'routine,' U of T researcher finds noreen.rasbach Tue, 03/26/2019 - 00:00

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Quinn Grundy is an assistant professor at U of T's Lawrence S. Bloomberg Faculty of Nursing (photo by Susan Merrell)

Topic

Lawrence S. Bloomberg Faculty of Nursing

Research & Innovation

Technology

Mobile health apps for consumers and clinicians pose a risk to patients’ privacy, an international study led by the �ؿ�ζSM has found.

Mobile health apps are a booming market targeted at both patients and health professionals. Some apps help patients track and learn more about their prescription medications, while others provide information to clinicians to help them prescribe and administer medications. Both types pose a heightened risk to patients’ privacy, the study found.

“Most health apps fail to provide privacy assurances or transparency around data-sharing practices,” said Quinn Grundy, an assistant professor at U of T's Lawrence S. Bloomberg Faculty of Nursing who led the study.

“User data collected from apps providing medicines information or support may also be particularly attractive to cybercriminals or commercial data brokers.”

The peer-reviewed study, published recently in the BMJ, identified the 24 top-rated, medicines-related apps for the Android mobile platform in Canada, the United States, the United Kingdom and Australia. The research revealed that 79 per cent of the apps share user data outside the app.

The international and multidisciplinary collaborative research team from the �ؿ�ζSM, the University of Sydney and the University of California, Santa Barbara also discovered that sharing of user data is routine, but far from transparent.

Researchers investigated apps that were available to the public on the Android platform, provided information about medicines, and were interactive. Of the 24 apps investigated, most shared personal data including username, medicines searched, medical conditions, device ID and email address. The study found a total of 55 unique entities, owned by 46 parent companies, received or processed this user data, including developers, parent companies (first parties) and service providers (third parties).

The majority (about two-thirds) of these third parties provided services related to analysis of user data, including targeted advertising.

To conduct the study, researchers ran a laboratory-based traffic analysis of each app downloaded onto a smartphone, simulating real-world use with dummy scripts. Privacy leaks were detected using a technique called Differential Traffic Analysis. Researchers ran the app 14 times to establish the app’s normal baseline functioning network traffic, then changed one aspect of the user’s profile, such as location, and inferred privacy leaks from any change in the network traffic. Researchers identified the companies directly receiving user data from their IP addresses and domain names.

Researchers then searched the websites and the privacy policies of the third parties receiving user data and found that they reported further sharing of anonymized data with additional commercial entities, termed “fourth parties."

Third parties advertised the ability to share user data with 216 of the fourth parties, including multinational technology companies, digital advertising companies, telecommunications corporations, and a consumer credit reporting agency. Only three of these fourth parties could be characterized predominantly as belonging to the health sector. A small number of commercial entities – such as Facebook and Alphabet (Google’s parent company) – had the ability to potentially aggregate and re-identify user data.

While it is unclear whether medicines-related apps share user data more or less than other health apps or apps in general, the findings raise privacy concerns for consumers and clinicians alike. Mobile apps are not generally required to have clear privacy policies, and researchers are calling for increased transparency and regulation.

“Privacy regulators should consider that loss of privacy is not a fair cost for the use of digital health services,” Grundy said. “Regulators should emphasize the accountabilities of those who control and process user data, while health app developers should disclose all data-sharing practices and allow users to choose precisely what data are shared and where.”

The research was supported by the Canadian Institutes of Health Research and the Sydney Policy Lab.

Read the research in the BMJ

(graphic by Jazmin Ozsvar)

U of T report explores workers’ experience in the global gig economy

noreen.rasbach — Wed, 23 May 2018 15:32:55 +0000

U of T report explores workers’ experience in the global gig economy

noreen.rasbach Wed, 05/23/2018 - 11:32

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(photo by Lorenzo Cafaro via Pexels)

Lindsay Curtis

Nicole Bodnar

Topic

Global Lens

Bloomberg Faculty of Nursing

Dalla Lana School of Public Health

Employment

Health

Research & Innovation

Subheadline

Rise in temporary contract work and income insecurity has far-reaching health implications

A report by �ؿ�ζSM researchers exploring the rapidly growing gig economy reveals new insights and a deeper understanding of how online platform-mediated work has the potential to transform the future of work and health in Canada and internationally.

“Gig work presents potential opportunities and vulnerabilities for workers, but little is known about their experience in this new labour market,” said Principal Investigator Denise Gastaldo, associate professor at U of T’s Bloomberg Faculty of Nursing and director of the Centre for Critical Qualitative Health Research at the Dalla Lana School of Public Health.

In the context of the rise of digital platform businesses, “gigs” are short-term, temporary contracts that are typically low paid and provide no training, health, or retirement benefits. More and more Canadians are participating in the gig economy, a trend with significant health implications, especially related to precarious work and income insecurity – major predictors of disease.

According to the recently published report, Towards an Understanding of Workers in the Global Gig Economy, measuring the size of the gig economy is challenging because the work is largely invisible and not captured by existing labour market statistics and economic indicators. What is known is the number of people in Toronto who describe their job as “temporary” grew by 40 per cent between 1997 and 2013.

“Studies show the tension between opportunity and vulnerability for workers, but too little is known about how these advantages and disadvantages are experienced differently across demographics and regions,” said Uttam Bajwa, lead author of the report and research associate with Dalla Lana's office of global public health education and training.

This shift in the workforce and structure of employment has major implications for the Canadian and global economy. Global and country-level policies have not kept pace with the “gigification” of the labour market, leaving gig workers excluded from existing skills development, health and social protection policies, all of which are designed for the traditional labour market.

Although the stereotype of the typical gig worker is that they are young, white, and male, this too is changing quickly. Groups associated with precarious work, such as women, immigrants, youth and older workers, are also participating. Gig work also has major implications for the socio-economic well-being of workers.

Read the report

“Gig workers share occupational vulnerabilities and aspects of precarity (e.g. income insecurity) with other workers, but they must also contend with platform-based vulnerabilities, such as social isolation, platform businesses’ control of pricing and workflow, and work-related stress due to surveillance,” said Bajwa.

The report provides frameworks for approaching gig worker vulnerabilities, underscores the importance of exploring the knowledge gaps, and the need for further research on the social, economic, and health implications of gig work.

This research was supported by the Social Sciences and Humanities Research Council of Canada. The research was also supported with in-kind contributions from U of T's Bloomberg Faculty of Nursing and the Dalla Lana School of Public Health.

Mindfest: ending the stigma around mental health and well-being

lavende4 — Mon, 03 Oct 2016 14:38:03 +0000

Mindfest: ending the stigma around mental health and well-being

lavende4 Mon, 10/03/2016 - 10:38

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Mindfest takes place at Hart House on October 5.

Lindsay Curtis

Author legacy

Lindsay Curtis

Topic

As a child, Emily Wright suffered from bullying, a learning disability and sexual assault. By her 20s she was living on the streets with a crack cocaine addiction. The Toronto resident will share her remarkable story of courage and recovery at Mindfest, a free Hart House mental health and wellness fair on Wednesday, October 5.

“Conversations about struggle are important because without them, people struggle silently and alone,” says Wright. “Mindfest brings together the voices and contributions of people with lived mental health experiences in the community.”

Wright grew up in a loving and supporting home in the Rosedale neighbourhood of Toronto. Her home life was idyllic — but her school life was excruciating and painful. Cruel bullying chipped away at her self-esteem, following her wherever she went.

Wright changed schools seven times over the course of 10 years. After being diagnosed with a learning disability and having been sexually assaulted by a schoolmate, Wright turned to drug use. With her life and addiction flying out of control, Wright was admitted to the hospital at age 15. Three years, 12 treatment centres, and a cross-country care-seeking journey later, she returned to Toronto and began living on the streets with a crack addiction.

Homeless for the better part of a year, Wright found her way to Eva’s Phoenix - a youth shelter that helps teens transition out of homelessness. With the support she needed, Wright worked tirelessly toward finding her passion and worth, when she discovered her love of working with children. Having found confidence for the first time, she went on to complete high school, university and move into her own apartment.

Today, Wright talks about her experiences bravely and openly. Her story, Gone Girl, was published in Toronto Life Magazine in November 2014. Now a highly sought-after public speaker, Wright works as an early childhood educator in a kindergarten classroom, working to ensure the children in her classroom have positive educational experiences. As an educator, Wright is committed to putting an end to bullying and fostering social justice.

Wright’s story reminds us that no one is immune to mental health struggles, addiction, or homelessness. Mindfest raises awareness about resources for help and aims to end the stigma around mental health and well-being.

Free and open to the public, Mindfest gives attendees the opportunity to learn, engage, and become active participants in dismantling stigma and creating awareness about mental health.

Mindfest takes place Wednesday, October 5^th at Hart House (7 Hart House Circle).

Visit www.mindfest.ca for the day’s full speaker & workshop line-up.