Papers by Nandini Maharaj
Current Oncology
This study assessed the feasibility, acceptability and potential effects of True North Peer Navig... more This study assessed the feasibility, acceptability and potential effects of True North Peer Navigation (PN)—a web-based peer navigation program for men with prostate cancer (PC) and their family caregivers. A one-arm, pre-post pilot feasibility study was conducted at two cancer centres in Canada. Participants were matched through a web-app with a specially trained peer navigator who assessed needs and barriers to care, provided support and encouraged a proactive approach to health for 3 months. Descriptive statistics were calculated, along with paired t-tests. True North PN was feasible, with 57.9% (84/145) recruitment, 84.5% (71/84) pre-questionnaire, 77.5% (55/71) app registration, 92.7% (51/55) match and 66.7% (34/51) post-questionnaire completion rates. Mean satisfaction with Peer Navigators was 8.4/10 (SD 2.15), mean program satisfaction was 6.8/10 (SD 2.9) and mean app usability was 60/100 (SD 14.8). At 3 months, mean ± SE patient/caregiver activation had improved by 11.5 ± 3....
Detailed themes and subthemes from the qualitative data analyses. Tables (Appendices 1–15) with t... more Detailed themes and subthemes from the qualitative data analyses. Tables (Appendices 1–15) with the count of themes and sub-themes, and for each province. (DOCX 70 kb)
Supportive Care in Cancer, 2020
Cancer navigation improves access to support and reduces barriers to care; however, appropriate t... more Cancer navigation improves access to support and reduces barriers to care; however, appropriate training of navigators is essential. We developed the TrueNTH Peer Navigation Training Program (PNTP), a competency-based, blended online/in-person course. In this study, we evaluate the feasibility, acceptability, and effectiveness of the PNTP among prostate cancer (PC) survivors (patients, caregivers). We employed an explanatory mixed method study design consisting of course usage data, pre-/post-questionnaires, and focus groups informed by the Kirkpatrick framework and self-efficacy theory. Three cohorts in two Canadian cities (n = 26) received the PNTP. Participants were motivated to support others like themselves (n = 20), fill a gap (n = 7), pay it forward (n = 6), and offer expertise (n = 4). Recruitment, retention, and questionnaire completion were 96.7%, 89.6%, and 92%. Participants contributed a total of 426 posts to the online forums (2 to 3 posts per participant/module). Satisfaction was 9.4/10 (SD = 0.7) and usability was 84.5/100 (SD = 10.1). All learning outcomes increased: understanding of learning objectives t(23) = − 6.12, p < 0.0001; self-efficacy to perform competencies t(23) = − 4.8, p < 0.0001; and eHealth literacy t(23) = − 4.4, p < 0.0001. Participants viewed the PTNP as intensive but manageable, improving knowledge and confidence and enhancing listening skills. Participants valued the flexibility of online learning, interactive online learning, in-person interactions for relationship building, and authentic role-playing for skill development. A facilitated online training program with in-person components is a highly acceptable and effective format to train PC survivors to become peer navigators. This competency-based peer navigator training program and delivery format may serve as a useful model for other cancer volunteer programs.
Western journal of nursing research, Jan 4, 2014
Using a qualitative design, the purpose of this study was to examine how people describe their re... more Using a qualitative design, the purpose of this study was to examine how people describe their relationship with their dog and what they do that suggest this bond represents a meaningful relationship. Dog owners (N = 27) aged 19 years and older were invited to participate in one of seven focus group discussions. A qualitative content analysis revealed the presence of three themes: (a) the impact of dogs on interpersonal relationships, (b) dogs as subjective beings, and (c) psychological and health benefits of dogs. The second theme reflects the personal agency of dogs and their unique contributions to the human-dog relationship. These themes are discussed in light of the current research in the field. The findings suggest implications for counseling research and practice in improving the health and well-being of dog owners.
Supportive Care in Cancer, 2019
Purpose Trained peer navigators can offer valuable peer support and mentorship to cancer patients... more Purpose Trained peer navigators can offer valuable peer support and mentorship to cancer patients and caregivers due to their highly relevant and unique perspective about the disease experience. In order to define the role of prostate cancer (PC) peer navigators within the cancer care system, it is important to establish the essential competencies of a PC peer navigator. We systematically identified and verified a set of core competencies for PC peer navigators and present a competency framework for PC peer navigators. Methods In phase 1, we conducted formative research consisting of a literature review and environmental scan as well as a secondary analysis of qualitative interviews. In phase 2, we drafted and mapped competencies. Finally in phase 3, expert stakeholders completed an anonymous survey to indicate whether they endorsed the competencies and to rank the importance of each competency to the peer navigator role. Open-ended feedback was also provided for each competency. Results Six core competency domains emerged: (1) self as navigator, (2) communication, (3) knowledge/information, (4) facilitate patient-centred care, (5) eHealth/technology, and (6) caregiver needs. Forty-seven core competency statements were mapped to these domains. Expert stakeholders (n = 27) included cancer survivors, caregivers, and healthcare providers. Most (89%) of core competency statements were endorsed by stakeholders and received high priority ratings, whereas only five of the competencies were less uniformly endorsed. Conclusions This is the first attempt to list core competencies for PC peer navigators and may offer guidance for standardizing the PC peer navigator role and training.
Journal of Spirituality in Mental Health, 2016
Human beings attempt to find meaning in their everyday lives. The relational significance of the ... more Human beings attempt to find meaning in their everyday lives. The relational significance of the human-animal bond is no exception. This article draws upon a qualitative study examining the subjective experience of living with a companion dog. Dog owners (n = 27) were invited to participate in focus groups. Based on a thematic analysis, three themes are highlighted: (a) this is a sacred relationship; (b) all we have is today; and (c) I’m going to fix you, hang on. Discussed in light of interdisciplinary perspectives, these findings may lead to a deeper understanding of the human-animal bond in research and clinical work.
Educational Studies, 2020
Phenomenological reflection can refer to methods for analyzing empirical data and, more broadly, ... more Phenomenological reflection can refer to methods for analyzing empirical data and, more broadly, to a guiding philosophy that can be used to facilitate reflection upon an experience or phenomenon. Such reflection can help to uncover assumptions that would otherwise remain implicit or taken for granted. Common practice in phenomenology is to gather insights from various sources (e.g. poems, legends) in order to enrich our understanding of the phenomenon. Grounded in the writing of Max van Manen, the author provides a phenomenological reflection on the experience of studying Latin and translating poetry, as a defense of the liberal arts. In doing so, the author suggests that the goal of evaluating one’s education primarily in terms of its practical or technical value may itself have to be reconsidered.
The Clearing House: A Journal of Educational Strategies, Issues and Ideas
Counselling Psychology Quarterly
Illness, Crisis & Loss
Survivorship concerns are common after prostate cancer with many survivors experiencing long-term... more Survivorship concerns are common after prostate cancer with many survivors experiencing long-term and late effects of treatment. Patient navigation has been promoted to improve continuity of care. While many studies have examined the potential benefits of patient navigation by health-care professionals for the screening and diagnostic phase, few are focused on peer navigation for prostate cancer patients in the treatment and posttreatment survivorship phase. The purpose of this qualitative descriptive study was to explore the perceptions of men with prostate cancer and the partners of such men regarding their support needs and experiences. In depth, semistructured interviews were conducted with 20 men who were prostate cancer survivors and 4 partners. Qualitative thematic analysis was used to identify themes and patterns across the interviews. According to the results, participants had experienced uncertainty regarding their test results and treatment options. Many participants had ...
Ethics and Social Welfare
Loisir et Société / Society and Leisure
BMC Geriatrics
Background: Frail seniors often receive ineffective care, which does not meet their needs. It is ... more Background: Frail seniors often receive ineffective care, which does not meet their needs. It is still unclear how healthcare systems should be redesigned to be more sensitive to the needs and values of frail seniors and their caregivers. We thus aimed to describe key stakeholders' perspectives on the current healthcare and services available to frail seniors. Methods: In this qualitative descriptive study, we conducted semi-structured interviews with a convenience sample of 42 frail seniors, caregivers, clinicians, or healthcare administrators/decision makers involved in frail senior care from five Canadian provinces. We explored participants' perspectives on the quality of care and services for frail seniors. We used an inductive/deductive thematic data analysis approach based on the Square-of-Care model, including emerging themes using the constant comparison method. Results: We grouped participants' perspectives into strengths, weaknesses and opportunities for improvement, and then into nine themes: care processes, continuity of care, social frailty, access to healthcare and services, models of healthcare delivery, cost of care, healthcare staff management and professional development of healthcare providers, material resources and environmental design of healthcare facilities, and coordination of care. Our findings suggest redesigning assessment, communication with frail seniors and their caregivers, targeting care and services to the needs, and integrating care better across settings and in time. Conclusions: A systematic identification of frail older people is the first step to adapt healthcare systems to this population's needs. Participation of frail older people and their caregivers to decision making would also allow choosing care plans meeting their care goals. The integration of care and services across settings, over time, and with various providers, is also needed to meet frail senior needs.
Reflective Practice, 2016
Journal of Family Violence, 2016
Journal of Loss and Trauma, 2015
Journal of Allergy and Clinical Immunology, 2011
Background-Low socioeconomic status (SES) is a strong predictor of many health problems, includin... more Background-Low socioeconomic status (SES) is a strong predictor of many health problems, including asthma impairment; however, little is understood about why some individuals defy this trend by exhibiting good asthma control despite living in adverse environments. Objective-This study sought to test whether a psychological characteristic -"shift-and-persist" (dealing with stressors by reframing them more positively, while at the same time, persisting in optimistic thoughts about the future) -protects low SES children with asthma. Methods-121 children physician-diagnosed with asthma, ages 9-18, were recruited from medical practices and community advertisements (M age=12.6, 67% male, 61% Caucasian). Shiftand-persist and asthma inflammation (eosinophil counts, stimulated IL-4 cytokine production) were assessed at baseline, and asthma impairment (daily diary measures of rescue inhaler use and school absences), and daily peak flow were monitored at baseline and at a 6-month follow-up. Results-Children who came from low SES backgrounds but who engaged in shift-and-persist strategies displayed less asthma inflammation at baseline (β=.19, p<.05), as well as less asthma impairment (reduced rescue inhaler use and fewer school absences; β=.32, p<.01) prospectively at a 6 month follow-up period. In contrast, shift-and-persist strategies were not beneficial among high SES children with asthma. Conclusion-An approach that focuses on the psychological qualities that low SES children develop to adapt to stressors may represent one practical and effective starting point for reducing health disparities. Moreover, the approaches that are effective in low SES communities may be different from those that are optimal in a high SES context.
Western journal of nursing research, Jan 4, 2014
Using a qualitative design, the purpose of this study was to examine how people describe their re... more Using a qualitative design, the purpose of this study was to examine how people describe their relationship with their dog and what they do that suggest this bond represents a meaningful relationship. Dog owners (N = 27) aged 19 years and older were invited to participate in one of seven focus group discussions. A qualitative content analysis revealed the presence of three themes: (a) the impact of dogs on interpersonal relationships, (b) dogs as subjective beings, and (c) psychological and health benefits of dogs. The second theme reflects the personal agency of dogs and their unique contributions to the human-dog relationship. These themes are discussed in light of the current research in the field. The findings suggest implications for counseling research and practice in improving the health and well-being of dog owners.
Uploads
Papers by Nandini Maharaj