Lela V. Zimmer

Bio: Lela V. Zimmer is an academic researcher from University of Northern British Columbia. The author has contributed to research in topics: Rural Nursing & Nurse education. The author has an hindex of 6, co-authored 10 publications receiving 498 citations.

Qualitative meta-synthesis: a question of dialoguing with texts.

Abstract: Aims. This paper discusses whether useful synthesis of research reports across different qualitative methodologies is possible, and whether qualitative meta-synthesis violates the tenets of the interpretive paradigm. Background. Qualitative meta-synthesis is a recent development in qualitative inquiry that offers a means of enhancing the contribution of qualitative findings to the development of more formalized knowledge. However, there are a number of unanswered questions and areas that require debate. Discussion. A brief overview of qualitative meta-synthesis as a method of inquiry is presented. The assumptions of phenomenology, ethnography and grounded theory are explored for their amenability to meta-synthesis and the possibility of coherent synthesis of findings across these methodologies. In addition, a summary of major philosophical commitments common to the interpretive paradigm is presented. Qualitative meta-synthesis as a methodology is then explored for its fit within this paradigm. An argument is made, with some caveats, for synthesis across qualitative methodologies. Gadamer's concepts of the hermeneutic circle, the fusion of horizons, and dialogue with the text are explored for the insight they provide into the place of qualitative meta-synthesis in inquiry. Conclusion. It is important for researchers to bring hermeneutic skill to the process of meta-synthesis in order to develop a comprehensive understanding of the various philosophical assumptions in which qualitative approaches are based. The particular challenge of combining analysis and interpretation from studies with markedly different approaches and intentions may prompt synthesists to create new and innovative approaches to the presentation of meta-synthesis.

Nurses who work in rural and remote communities in Canada: a national survey

Abstract: In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization Two thirds of the nurses grew up in a community of under 10 000 people While nurses’ levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons Important variations were noted by nurse type and region The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote settings Survey results about the characteristics and practice of the various types of nurses can support workforce planning to improve nursing services and access to care

Professionalism in Rural Acute-Care Nursing

Abstract: Professionalism is commonly discussed in nursing but little is known about how it is experienced in everyday nursing practice.This study examines rural nurses experiences of professionalism and articulates the nature of professionalism in rural acute-care settings. Interview data from 8 nurses in rural acute-care facilities in British Columbia and Alberta, Canada, were analyzed using an interpretive description approach.The findings indicate that professionalism among rural nurses is a dynamic, enduring phenomenon that exists in workplace and community contexts.To experience professionalism in rural nursing means being visible in the community while embracing reality in the workplace. Understanding professionalism in a rural context has significant implications in terms of affirming and identifying sources ofjob satisfaction among rural nurses and creating professional practice environments in rural areas.

Rethinking emancipation and empowerment in action research: lessons from small rural hospitals.

Abstract: A primary goal of action research is social change that is driven largely by the research participants. A major assumption is that through the research process, participants are enabled to take knowledgeable action in their personal, work, or community environments, and that through this action they experience empowerment. Another is that action becomes possible as a result of enlightenment and emancipation through participation in the research. These assumptions were called into question during the course of an interpretive action research study conducted with nurses employed in 3 small rural hospitals in northern British Columbia, Canada. Examination of the issues that emerged during the study illuminates the ways in which nurses' professional and community lives are intertwined. This interconnection provoked a re-examination of how empowerment and emancipation can be realized by nurses in small rural hospitals.

Recruitment and Retention in Rural Nursing: It’s Still an Issue!

Abstract: A perennial issue for rural and remote communities in Canada and in other parts of the world is access to a healthcare delivery system including healthcare personnel to provide care to their residents. In total, 18% of Canadians live in rural locations but by proportion have fewer healthcare providers compared with urban settings. Relying on a recently completed documentary analysis of published reports and grey literature on rural and remote nursing practice from Canada and around the world, we recognize that recruitment and retention will be a recurring issue. However, a variety of programs and initiatives have been developed to address this age-old problem. A discussion is provided about educational opportunities, financial incentives and enhanced infrastructure that have been developed to address recruitment and retention challenges. Ongoing evaluations of each of these areas are necessary but require cooperation across provincial and national settings.

Purposeful sampling in qualitative research synthesis

Abstract: Informed decisions about sampling are critical to improving the quality of research synthesis. Even though several qualitative research synthesists have recommended purposeful sampling for synthesizing qualitative research, the published literature holds sparse discussion on how different strategies for purposeful sampling may be applied to a research synthesis. In primary research, Patton is frequently cited as an authority on the topic of purposeful sampling. In Patton’s original texts that are referred to in this article, Patton does not make any suggestion of using purposeful sampling for research synthesis. This article makes a unique contribution to the literature by examining the adaptability of each of Patton’s 16 purposeful sampling strategies to the process of qualitative research synthesis. It illuminates how different purposeful sampling strategies might be particularly suited to constructing multi‐perspectival, emancipatory, participatory and deconstructive interpretations of published research.

Validity, reliability, and generalizability in qualitative research

Abstract: In general practice, qualitative research contributes as significantly as quantitative research, in particular regarding psycho-social aspects of patient-care, health services provision, policy setting, and health administrations. In contrast to quantitative research, qualitative research as a whole has been constantly critiqued, if not disparaged, by the lack of consensus for assessing its quality and robustness. This article illustrates with five published studies how qualitative research can impact and reshape the discipline of primary care, spiraling out from clinic-based health screening to community-based disease monitoring, evaluation of out-of-hours triage services to provincial psychiatric care pathways model and finally, national legislation of core measures for children's healthcare insurance. Fundamental concepts of validity, reliability, and generalizability as applicable to qualitative research are then addressed with an update on the current views and controversies.

Justifying Knowledge, Justifying Method, Taking Action: Epistemologies, Methodologies, and Methods in Qualitative Research

Abstract: In this article, the authors clarify a framework for qualitative research, in particular for evaluating its quality, founded on epistemology, methodology, and method. They define these elements and discuss their respective contributions and interrelationships. Epistemology determines and is made visible through method, particularly in the participant- researcher relationship, measures of research quality, and form, voice, and representation in analysis and writing. Epistemology guides methodological choices and is axiological. Methodology shapes and is shaped by research objectives, questions, and study design. Methodologies can prescribe choices of method, resonate with particular academic disciplines, and encourage or discourage the use and/or development of theory. Method is constrained by and makes visible methodological and epistemic choices. If we define good quality qualitative research as research that attends to all three elements and demonstrates internal consistency between them, standardized checklists can be transcended and innovation and diversity in qualitative research practice facilitated.

Effects of parental involvement on academic achievement: a meta-synthesis

Abstract: The impact of parental involvement on student academic achievement has been recognized by teachers, administrators, and policy-makers who consider parental involvement to be one of the integral parts of new educational reforms and initiatives. This study synthesized the results of nine meta-analyses that examined this impact and it identified generalizable findings across these studies. The results indicated that the relationship between parental involvement and academic achievement was positive, regardless of a definition of parental involvement or measure of achievement. Furthermore, the findings revealed that this relationship was strongest if parental involvement was defined as parental expectations for academic achievement of their children. However, the impact of parental involvement on student academic achievement was weakest if parental involvement was defined as homework assistance. Finally, the relationship between parental involvement and academic achievement was found to be consistent across d...