Reverse innovation has been promoted as a solution to public health challenges in developing coun... more Reverse innovation has been promoted as a solution to public health challenges in developing countries, but reframing the concept as "innovation acquisition" can help avoid echoes of colonialism while refocusing the innovative process on achieving specific healthcare goals.
This article describes the development of a theater script derived from a critical ethnographic s... more This article describes the development of a theater script derived from a critical ethnographic study that followed people living with dementia—and their family and professional caregivers—over an 18-month period. Analysis of the ethnographic data yielded four themes that characterized home-based dementia care relationships: managing care resources, making care decisions, evaluating care practices, and reifying care norms. The research team expanded to include a colleague with playwright experience, who used these themes to write a script. A theater director was included to cast and direct the play, and finally, a videography company filmed the actors on a realistic set. To contribute to the qualitative health research and the research-based theater knowledge translation literatures, this article describes and explains the creative decisions taken as part of our effort to disseminate research focused on home-based dementia care in a way that catalyzes and fosters critical (actionabl...
Patient engagement is a challenge many leaders are facing, as consumer expectations of health ser... more Patient engagement is a challenge many leaders are facing, as consumer expectations of health services demand a more personalized approach to care. This article examines consumer trends that are influencing patient engagement and empowerment relative to the use of digital technologies. Informed by consumer and population health trends that can personalize health services, three strategies leaders can engage to strengthen patient experience include placing greater focus on personal health and wellness, shifting towards personalized rather than standardized healthcare, and facilitating the democratization of healthcare information.
Theories about how knowledge is sought and applied in clinical practice are often referred to as ... more Theories about how knowledge is sought and applied in clinical practice are often referred to as practice epistemologies, and have not been extensively explored in the physiotherapy profession. Tacit assumptions about what counts as physiotherapy knowledge thus form the basis for many approaches to gaining and using information in practice. The purpose of this paper is to propose a physiotherapy practice epistemology, through the notion of the bricoleur, which takes an alternative approach to understanding how knowledge might best be viewed in relation to physiotherapy. The term bricoleur refers to a handyman or handywoman who uses all tools and types of knowledge available. The notion of physiotherapists as bricoleurs recognizes that all practice knowledge is situated within social, cultural, and historical contexts that shape our beliefs about what counts as physiotherapy knowledge. This recognition leads physiotherapists who act as bricoleurs to embrace multiple epistemologies, discovering new ways of knowing and clinical reasoning strategies to provide a more holistic approach to physiotherapy practice. The relationships between expertise in clinical reasoning and the epistemology of the bricoleur are then addressed, explicating the utility of multiple epistemologies in achieving excellent physiotherapy care. A bricoleur's epistemology is then applied to the concept of expertise in physiotherapy, de-stabilizing the notion that a single authoritative approach to the practice of physiotherapy ought to be idealized.
Two issues have been central to ongoing disputes about judgments of quality in qualitative inquir... more Two issues have been central to ongoing disputes about judgments of quality in qualitative inquiry: (a) the ways in which paradigmatic orientations are understood to guide procedural decisions and (b) the meaning and intelligibility of paradigmatic incommensurability. In this article, we address these two key issues through an exploration of the debates between hermeneutics and critical social theory, including the exchanges between Hans-Georg Gadamer and Jurgen Habermas, and between Richard Rorty and Thomas McCarthy. We suggest that the key epistemological issue addressed in these debates is the nature of interpretation, separating the two philosophical camps based on beliefs about whether foundational knowledge is possible to achieve. We conclude the article by discussing the implications of these different positions for beliefs about quality in qualitative inquiry, and comment on the role of judgment in assessments of the value and quality of different approaches to qualitative r...
This paper describes an initiative aimed at building the capacity of community volunteers to unde... more This paper describes an initiative aimed at building the capacity of community volunteers to understand and meet the needs of an increasingly aged population with complex needs. It begins by providing an overview of the benefits of volunteering (for volunteers themselves, for recipients, and for society at large) and of the taxing effect frailty has on our healthcare system. This provides a backdrop against which we describe the conceptualization, design, and pilot evaluation of “Lean on Me,” a four-part training program developed to enhance the way in which senior volunteers can support frail seniors’ participation in community programs.
This critical ethnographic study examined how power relations shape the nature and enactment of c... more This critical ethnographic study examined how power relations shape the nature and enactment of caregivers' evaluation of home-based dementia care practices. As the home care sector continues to evolve and prepare itself as a key element in caring for people living with dementia and their families, this study grounds our understanding of how dementia home care practices are enacted and evaluated, particularly at the interface of formal and familial caregiving. The critical finding from our data is that not all evaluations of care practices were considered equally meaningful or relevant, and, moreover, their significance depended on whether the evaluation was made by someone in a position of power. Renewed awareness of and attention to power relations, such as class and gender, are implicated in the evaluation of care practices. Consequently, challenging how power is enacted in ways that (re)produces and reifies care norms is vital in order to foster equitable and supportive partnerships in home-based dementia care.
Background Knowledge brokering is a knowledge translation approach that includes making connectio... more Background Knowledge brokering is a knowledge translation approach that includes making connections between researchers and decision-makers to facilitate the latter’s use of evidence in health promotion and the provision of healthcare. Despite knowledge brokering being well-established in Canada, many knowledge gaps exist, including understanding what theoretical frameworks have been developed and which evaluative practices knowledge brokers (KBs) use. Methods This study used a mixed methods design to examine how KBs in Canada (1) use frameworks, models and theories in their practice and (2) how they evaluate knowledge brokering interventions. We gathered interview and survey data from KB practitioners to better understand their perspectives on effective practices. Our analysis focused on understanding the theoretical frameworks used by KBs. Results This study demonstrates that KBs in Canada tend not to rely on theories or models that are specific to knowledge brokering. Rather, stu...
Reverse innovation has been promoted as a solution to public health challenges in developing coun... more Reverse innovation has been promoted as a solution to public health challenges in developing countries, but reframing the concept as "innovation acquisition" can help avoid echoes of colonialism while refocusing the innovative process on achieving specific healthcare goals.
This article describes the development of a theater script derived from a critical ethnographic s... more This article describes the development of a theater script derived from a critical ethnographic study that followed people living with dementia—and their family and professional caregivers—over an 18-month period. Analysis of the ethnographic data yielded four themes that characterized home-based dementia care relationships: managing care resources, making care decisions, evaluating care practices, and reifying care norms. The research team expanded to include a colleague with playwright experience, who used these themes to write a script. A theater director was included to cast and direct the play, and finally, a videography company filmed the actors on a realistic set. To contribute to the qualitative health research and the research-based theater knowledge translation literatures, this article describes and explains the creative decisions taken as part of our effort to disseminate research focused on home-based dementia care in a way that catalyzes and fosters critical (actionabl...
Patient engagement is a challenge many leaders are facing, as consumer expectations of health ser... more Patient engagement is a challenge many leaders are facing, as consumer expectations of health services demand a more personalized approach to care. This article examines consumer trends that are influencing patient engagement and empowerment relative to the use of digital technologies. Informed by consumer and population health trends that can personalize health services, three strategies leaders can engage to strengthen patient experience include placing greater focus on personal health and wellness, shifting towards personalized rather than standardized healthcare, and facilitating the democratization of healthcare information.
Theories about how knowledge is sought and applied in clinical practice are often referred to as ... more Theories about how knowledge is sought and applied in clinical practice are often referred to as practice epistemologies, and have not been extensively explored in the physiotherapy profession. Tacit assumptions about what counts as physiotherapy knowledge thus form the basis for many approaches to gaining and using information in practice. The purpose of this paper is to propose a physiotherapy practice epistemology, through the notion of the bricoleur, which takes an alternative approach to understanding how knowledge might best be viewed in relation to physiotherapy. The term bricoleur refers to a handyman or handywoman who uses all tools and types of knowledge available. The notion of physiotherapists as bricoleurs recognizes that all practice knowledge is situated within social, cultural, and historical contexts that shape our beliefs about what counts as physiotherapy knowledge. This recognition leads physiotherapists who act as bricoleurs to embrace multiple epistemologies, discovering new ways of knowing and clinical reasoning strategies to provide a more holistic approach to physiotherapy practice. The relationships between expertise in clinical reasoning and the epistemology of the bricoleur are then addressed, explicating the utility of multiple epistemologies in achieving excellent physiotherapy care. A bricoleur's epistemology is then applied to the concept of expertise in physiotherapy, de-stabilizing the notion that a single authoritative approach to the practice of physiotherapy ought to be idealized.
Two issues have been central to ongoing disputes about judgments of quality in qualitative inquir... more Two issues have been central to ongoing disputes about judgments of quality in qualitative inquiry: (a) the ways in which paradigmatic orientations are understood to guide procedural decisions and (b) the meaning and intelligibility of paradigmatic incommensurability. In this article, we address these two key issues through an exploration of the debates between hermeneutics and critical social theory, including the exchanges between Hans-Georg Gadamer and Jurgen Habermas, and between Richard Rorty and Thomas McCarthy. We suggest that the key epistemological issue addressed in these debates is the nature of interpretation, separating the two philosophical camps based on beliefs about whether foundational knowledge is possible to achieve. We conclude the article by discussing the implications of these different positions for beliefs about quality in qualitative inquiry, and comment on the role of judgment in assessments of the value and quality of different approaches to qualitative r...
This paper describes an initiative aimed at building the capacity of community volunteers to unde... more This paper describes an initiative aimed at building the capacity of community volunteers to understand and meet the needs of an increasingly aged population with complex needs. It begins by providing an overview of the benefits of volunteering (for volunteers themselves, for recipients, and for society at large) and of the taxing effect frailty has on our healthcare system. This provides a backdrop against which we describe the conceptualization, design, and pilot evaluation of “Lean on Me,” a four-part training program developed to enhance the way in which senior volunteers can support frail seniors’ participation in community programs.
This critical ethnographic study examined how power relations shape the nature and enactment of c... more This critical ethnographic study examined how power relations shape the nature and enactment of caregivers' evaluation of home-based dementia care practices. As the home care sector continues to evolve and prepare itself as a key element in caring for people living with dementia and their families, this study grounds our understanding of how dementia home care practices are enacted and evaluated, particularly at the interface of formal and familial caregiving. The critical finding from our data is that not all evaluations of care practices were considered equally meaningful or relevant, and, moreover, their significance depended on whether the evaluation was made by someone in a position of power. Renewed awareness of and attention to power relations, such as class and gender, are implicated in the evaluation of care practices. Consequently, challenging how power is enacted in ways that (re)produces and reifies care norms is vital in order to foster equitable and supportive partnerships in home-based dementia care.
Background Knowledge brokering is a knowledge translation approach that includes making connectio... more Background Knowledge brokering is a knowledge translation approach that includes making connections between researchers and decision-makers to facilitate the latter’s use of evidence in health promotion and the provision of healthcare. Despite knowledge brokering being well-established in Canada, many knowledge gaps exist, including understanding what theoretical frameworks have been developed and which evaluative practices knowledge brokers (KBs) use. Methods This study used a mixed methods design to examine how KBs in Canada (1) use frameworks, models and theories in their practice and (2) how they evaluate knowledge brokering interventions. We gathered interview and survey data from KB practitioners to better understand their perspectives on effective practices. Our analysis focused on understanding the theoretical frameworks used by KBs. Results This study demonstrates that KBs in Canada tend not to rely on theories or models that are specific to knowledge brokering. Rather, stu...
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