Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Kinesiology

Supervisor

Dr. Angela Dyan Mandich

2nd Supervisor

Dr. Jessie Wilson

Abstract

The purpose of this dissertation was to acquire a greater depth of knowledge surrounding the experiences of the interfacility transport process for acutely ill and preterm neonates based on the perspectives of healthcare professionals and parent-caregivers who are involved. In doing so, an overall goal was to develop a conceptual model that explains how healthcare professionals and parents experience the process while also offering insights into how to foster more positive experiences through clinical interventions that are aligned with Family Centred Care. This program of research is uniquely guided by the paradigms and theoretical frameworks of Trauma Informed Care (TIC), Family Centred Care (FCC) and Resilience.

This dissertation contains an introduction chapter and methodology chapter, three integrated articles, and a final discussion chapter. The project utilizes constructivist grounded theory methodology to carry out data collection and analysis. The first article is a systematic investigation into the nature and extent of empirical literature exploring healthcare professional experiences across all types of early healthcare transitions. The second article explores how a sample of six diverse professionals experience interfacility transport. The third article presents the findings of a sample of eight maternal experiences of neonatal interfacility transport during the COVID-19 pandemic. The final discussion chapter presents a conceptual model and provides insights into how trauma-informed care principles and professional resilience may be beneficial to consider in clinical practice within this unique context.

Summary for Lay Audience

This integrated-article dissertation contains three unique studies aimed at understanding what the experience of transporting preterm and acutely ill infants between neonatal intensive care units and regional hospitals is like for mothers and healthcare professionals. The first article provides an overview of the current body of literature considering healthcare professional experiences of early healthcare transitions. Early healthcare transitions are events that often occur when infants are born with medical complexities requiring specialized care or personnel. The second article considers healthcare professional experiences of interfacility transport in Ontario, Canada. The third article considers maternal experiences of interfacility transport in Ontario, Canada between the years of 2020 to 2022.

The guiding frameworks of Trauma Informed Care, Family Centered Care and Resilience were used to better understand how the process occurs. These concepts helped in developing an overall conceptual model for understanding the complexities of interfacility transport.

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