Kathy L Rush

University of British Columbia | UBC · School of Nursing

This scoping review assesses the current knowledge on technology-related safety events in primary and community care settings, focusing on patient safety and harm. Utilizing Arksey and O’Malley’s methodological framework, a comprehensive literature search was conducted across various databases, yielding 17 relevant articles. The review highlighted...

This case study presents a process that was iteratively developed for clinical informaticians to identify, analyse, and respond to safety events related to health information technologies (HIT) in community care settings (This research was supported by the CIHR Health Systems Impact Fellowship Program. We would also like to thank Vancouver Coastal...

Demand is emerging for personal health records (PHRs), a patient-centric digital tool for engaging in shared decision-making and healthcare data management. This study uses a RE-AIM framework to explore rural patients and providers’ perceptions prior to and following implementation of a PHR. Health care providers and their patients were recruited f...

Background Equity-deserving groups face well-known health disparities that are exacerbated by rural residence. Health technologies have shown promise in reducing disparities among these groups, but there has been no comprehensive evidence synthesis of outcomes. Purpose The purpose of this systematic review was to examine the patient, healthcare, a...

This systematic review evaluates the efficacy of self-care interventions for atrial fibrillation (AF), focusing on strategies for maintenance, monitoring, and management applied individually or in combination. Adhering to the 2020 PRISMA guidelines, the search strategy spanned literature from 2005 to 2023, utilizing keywords and subject headings fo...

Objective This study created personas using quantitative segmentation and knowledge user enhancement to inform intervention and service design for rural patients to encourage preventive care uptake. Methods This study comprised a cross-sectional survey of rural unattached patients and a co-design workshop for persona development. Cross-sectional s...

This study examined whether Indigenous peoples could achieve the Canadian Physical Activity Guidelines (CPAG) for adults while engaging in the cultural practice of hunting. It was hypothesized that Indigenous hunters would achieve or surpass the physical activity (PA) thresholds set forth by the CPAG on days spent hunting. Step count and heart rate...

Background Although intended to support improvement, the rapid adoption and evolution of technologies in health care can also bring about unintended consequences related to safety. In this project, an embedded researcher with expertise in patient safety and clinical education worked with a clinical informatics team to examine safety and harm relate...

Background The adoption of technology in health care settings is often touted as an opportunity to improve patient safety. While some adverse events can be reduced by health information technologies, technology has also been implicated in or attributed to safety events. To date, most studies on this topic have focused on acute care settings. Object...

Our objectives were to measure long-term adherence to oral anticoagulants (OACs) in patients with atrial fibrillation (AF) and to identify patient factors associated with adherence. Using linked, population-based administrative data from British Columbia, Canada, an incident cohort of adults prescribed OACs for AF was identified. We calculated the...

Caregivers of people living with dementia are pillars of the care community. Providing them with adequate support throughout their caregiving journey is essential to their quality of life and may also contribute to improving the care of people living with dementia. Nav-CARE (Navigation-Connecting , Advocating, Resourcing, Engaging) is a volunteer-l...

Background A number of real-world digital literacy training programs exist to support engagement with mobile devices, but these have been understudied. Objective The purpose of this study was to examine the effectiveness and program acceptability of a digital skills training program among middle-aged and older adults (aged ≥50 years) and to gather...

Background Patients with atrial fibrillation (AF) have significantly lower health-related quality of life (HRQoL) compared to the general population and patients with other heart diseases. The research emphasis on the influence of AF symptoms on HRQoL overshadows the role of individual characteristics. To address this gap, this study’s purpose was...

BACKGROUND Although intended to support improvement, the rapid adoption and evolution of technologies in health care can also bring about unintended consequences related to safety. In this project, an embedded researcher with expertise in patient safety and clinical education worked with a clinical informatics team to examine safety and harm relate...

Background: The purpose of this study was to design, usability test, and explore the feasibility of a web-based educational platform/intervention for patients with atrial fibrillation (AF) as part of their virtual AF care. Methods: Participants were patients attending a specialized AF clinic. The multiple mixed-methods design included website de...

Background Telehealth can optimize access to specialty care for patients with atrial fibrillation (AF). Virtual AF care, however, may not fit with the complex needs of patients with AF. Objective This study aims to explore the correlation among attitudes toward health care technologies, self-efficacy, and telehealth satisfaction as part of the fut...

Objective: Self-care is essential to improving heart failure patient outcomes. However, the knowledge and behaviours necessary for self-care decision making, such as symptom perception and management, are complex and require patient education. The objective of this study was to test the feasibility, acceptability, and potential effectiveness of a w...

Background Examining characteristics of patients with atrial fibrillation (AF) has the potential to help in identifying groups of patients who might benefit from different management approaches. Methods Secondary analysis of online survey data was combined with clinic referral data abstraction from 196 patients with AF attending an AF specialty cl...

BACKGROUND A number of real-world digital literacy training programs exist to support engagement with mobile devices, but these have been understudied. OBJECTIVE The purpose of this study was to examine the effectiveness and program acceptability of a digital skills training program among middle-aged and older adults (aged ≥50 years) and to gather...

BACKGROUND Telehealth can optimize access to specialty care for patients with atrial fibrillation (AF). Virtual AF care, however, may not fit with the complex needs of patients with AF. OBJECTIVE This study aims to explore the correlation among attitudes toward health care technologies, self-efficacy, and telehealth satisfaction as part of the fut...

Purpose This is a study protocol to co-create with knowledge users a core outcome set focused on middle-aged and older adults (40 years+) for use in social prescribing research. Methods We will follow the Core Outcome Measures in Effectiveness Trials (COMET) guide and use modified Delphi methods, including collating outcomes reported in social pre...

Objective: Social prescribing is a complex care model, which aims to address unmet non-medical needs and connect people to community resources. The purpose of this systematic review was to synthesize available evidence from qualitative methods (e.g. interviews or focus groups) on experience, outcomes, and processes for social prescribing and older...

Background In-person health care has been the standard model of care delivery for patients with atrial fibrillation (AF). Despite the growing use of remote technology, virtual health care has received limited formal study in populations with AF. Understanding the virtual care experiences of patients in specialized AF clinics is essential to inform...

Aging in place has long been a policy objective in Canadian healthcare, with accompanying concerns about older adults in rural and remote regions, and growing interest in small urban areas as distinct from large urban ones. As one of the six health authorities in British Columbia (BC), Interior Health (IH) developed and implemented an innovative he...

Objective: Health sciences librarian roles are evolving to better meet the needs of faculty. This study explores nursing faculty needs at the University of British Columbia through the research lifecycle framework of planning, conducting, disseminating, and assessing the impact of their research. Methods: A mixed methods survey study with Likert s...

Background Rural and remote communities faced unique access challenges to essential services such as healthcare and highspeed infrastructure pre-COVID, which have been amplified by the pandemic. This study examined patterns of COVID-related challenges and the use of technology among rural-living individuals during the first wave of the COVID-19 pan...

Heart failure is a complex, chronic disease that requires self-care to manage, and patients need support and education to perform adequate self-care. Although electronic health interventions to support behavior change and self-care in cardiovascular disease are gaining traction, there is little engaging online education specifically designed for he...

Background Technology holds great potential for promoting health equity for rural populations, who have more chronic illnesses than their urban counterparts but less access to services. Yet, more participatory research approaches are needed to gather community‐driven health technology solutions. The purpose was to collaboratively identify and prior...

Technology has played a critical role during the COVID-19 pandemic. Despite affording a safe way for people to connect with others, the potential for problematic device usage (e.g., overuse, addiction) should be considered. The goal of this study was to examine mobile device use during the COVID-19 pandemic among rural and urban people in Canada. B...

Prevention services, such as screening tests and vaccination, are underutilized, especially by rural populations and patients without a usual primary care provider. Little is known about the compounding impacts on preventive care of being unattached and living in a rural area and there has been no comprehensive exploration of this highly vulnerable...

We investigated the uptake and perceptions of virtual care solutions by rural Canadian primary and specialist providers during the early phase (May-June 2020) of the COVID-19 pandemic. A web-based, cross-sectional survey of rural primary and specialty care providers examined types of virtual care platforms used (eg, phone, video), appointment lengt...

Background: Prior to the wider adoption of digital health technologies during the COVID-19 pandemic, applications of virtual care were largely limited to specialist visits and remote care using telehealth (phone or video) applications. Data sharing approaches using tethered patient portals were mostly built around hospitals and larger care systems....

Background Demand is emerging for personal health records (PHRs), a patient-centric digital tool for engaging in shared decision-making and healthcare data management. This study uses a RE-AIM framework to explore rural patients and providers’ perceptions prior to and following implementation of a PHR. Methods Health care providers and their patien...

People in rural and remote areas often experience greater vulnerability and higher health-related risks as a result of complex issues that include limited access to affordable health services and programs. During disruptive events, rural populations face unique barriers and challenges due to their remoteness and limited access to resources, includi...

Background To reduce person-to-person contact, the COVID-19 pandemic has driven a massive shift to virtual care. Defined as the use of technology (synchronous or asynchronous) to support communication between health care providers and patients, rural-urban differences in virtual care are relatively unexplored. Objective The 2-fold purpose of this s...

BACKGROUND The COVID-19 pandemic has driven a massive shift to virtual care to reduce person-to-person contact, though rural-urban differences are relatively unexplored. OBJECTIVE The two-fold purpose of the present study was to examine rural and urban virtual care access, use, and satisfaction during the pandemic and to identify any unmet needs....

Personal health records are increasingly being deployed in healthcare settings. In this study we explored patients’ perceptions of personal health records in a rural community in Canada where a primary health network is being deployed. A focus group was held and data were thematically analysed. All patients used technology on a regular basis. Theme...

Background Conventional adherence summary measures do not capture the dynamic nature of adherence. Objectives This study aims to characterize distinct long-term oral anticoagulant adherence trajectories and the factors associated with them in patients with atrial fibrillation. Methods Adults with incident atrial fibrillation were identified using...

Objectives: The purpose of this study was to understand the mental health experiences of adults 50 years of age and older living in a rural community in British Columbia. Methods: This study used critical social theory and interpretive description. Purposive sampling was used to recruit 8 adults aged 50 years and older. Participants used digital...

Background and Objectives Telehealth holds potential for inclusive and cost-saving healthcare; however, a better understanding of the use and acceptance of telehealth for health promotion among rural older adults is needed. This systematic review aimed to synthesize evidence for telehealth use among rural-living older adults and to explore cost-eff...

Background A recent systematic review highlighted significant gaps in the evidence on atrial fibrillation (AF) patients' adherence to oral anticoagulants (OAC). Current evidence suffers from short follow-up times, focuses on the first OAC and does not take switching into account. There is also lack of observational data on adherence to warfarin due...

Background Medication taking is a dynamic behaviour that changes over time. Conventional adherence summary measures (e.g. proportion days covered) used in the OAC adherence studies conducted so far, however, are insensitive to the fluid nature of adherence. For example, identical PDC values can be calculated for patients with initial good adherence...

BACKGROUND Medication taking is a dynamic behavior that changes over time. Conventional adherence summary measures (e.g. proportion days covered) used in the OAC adherence studies conducted so far, however, are insensitive to the fluid nature of adherence. For example, identical PDC values can be calculated for patients with initial good adherence...

BACKGROUND Studies measuring OAC adherence in AF patients have suffered from short follow-up times, inability to account for frequent medication switches and have excluded warfarin. Our objective was to compare AF patients’ long-term adherence between OACs and identify the impact of taking direct oral anticoagulants (DOAC) versus vitamin K antagoni...

Background Children with autism spectrum disorder (ASD) and their families experience challenges and barriers at multiple levels that influence their activity participation. The purpose of this study was to develop understanding about factors influencing how families can promote safe, active recreation for their children 3–12 years living with ASD...

BACKGROUND Prior to the wider adoption of digital health technologies during the COVID-19 pandemic, applications of virtual care were largely limited to specialist visits and remote care using telehealth (phone or video) applications. Data sharing approaches using tethered patient portals were mostly built around hospitals and larger care systems....

Background Promoting inclusive health and social care for rural populations requires new community-focused innovations, technological infrastructure, creative design thinking, and multi-stakeholder collaboration. Technology holds great potential for promoting health equity for rural populations, who have more chronic illnesses than their urban coun...

The COVID-19 pandemic has driven a greater reliance on telemedicine, yet rural access, use, and satisfaction with telemedicine and the role of eHealth literacy are unknown. Using a cross-sectional design, 279 (70.6% female) western rural Canadians completed an online survey. The majority of participants reported access to telemedicine, but nearly 1...

Background: Virtual care, increasingly mobilized during the COVID-19 pandemic, can enhance data-sharing between patients and providers, but little is known about it. The purpose of this study was to explore patient perspectives of data-sharing with providers during the COVID-19 pandemic as part of a larger study including primary care provider pers...

Objectives: The onset of the 2020 coronavirus pandemic resulted in rapid implementation of virtual care solutions at an unprecedented pace. The news media, as a trusted source for many Canadians, plays a vital role during emergencies by reporting on changes in health care protocols, policies, and technologies. This article presents the results of a...

Atrial fibrillation (AF) is the most common arrhythmia in the world. Despite the increasing prevalence, there remains a limited understanding of how the pre-diagnosis symptom experience varies by gender. The purpose of this study was to retrospectively explore gender differences/similarities in the pre-diagnosis period of AF. Twenty-six adults (13...

Objective The aim of this mixed methods systematic review was to: i) document the interventions that support and facilitate graduate nurse transition from university to practice in a diversity of healthcare settings and ii) to identify outcomes from graduate nurse transition interventions for the graduate, patient or client, and health service. De...

Background Personal health records (PHR) provide opportunities for improved patient engagement, collection of patient-generated data, and overcome health-system inefficiencies. While PHR use is increasing, uptake in rural populations is lower than in urban areas. Objectives The study aimed to identify priorities for PHR functionality and gain insi...

Background Whether advances in identification and management of atrial fibrillation and atrial flutter (collectively, AF) have led to improved outcomes is unclear. We sought to study trends in clinical outcomes selected as quality indicators for non-valvular AF in Canada. Methods We identified hospitalized patients with a first diagnosis of non-va...

Background: Atrial fibrillation is a complex condition associated with a broad spectrum of symptoms, coupled with variability in the frequency, duration and severity of symptoms. Early treatment seeking is important to reduce the risk of stroke, heart failure and dementia. Despite the increasing prevalence, there remains a limited understanding of...

Purpose To explore postanesthesia care unit (PACU) nurses' interactions with technology during the critical Phase I recovery period. Design Interpretive description was used to understand nurses' experiences. Methods Nine PACU nurses were recruited from three mid-sized hospitals within the same health authority in a Western Canadian province. Nur...

Objectives Diabetes rates in the British Columbia (B.C.) Interior are rising more rapidly compared to the rest of Canada while diabetes service provision is limited within this region. The purposes of this paper were (1) to identify characteristics of diabetes service delivery and (2) to co-develop community-university diabetes research projects to...

Approaches to and benefits from resistance training for non-compromised older adults are well known. Less is understood about resistance training with pre-frail older adults, and even less information is available on the practical approaches to delivery. Herein, we describe an approach in pre-frail females who undertook a multi-component exercise i...

Background: No study has performed an exercise intervention that included high-intensity, free- weight, functional resistance training, and assessed frailty status as an inclusion criteria and outcome measure via original, standardized tools, in pre-frail females. Objectives: Determine if the intervention strategy is not only feasible and safe, b...

Approaches to and benefits from resistance training for non-compromised older adults are well known. Less is understood about resistance training with pre-frail older adults, and even less information is available on the practical approaches to delivery. Herein, we describe an approach in pre-frail females who undertook a multi-component exercise i...

Background: Atrial fibrillation (AF), the most common form of dysrhythmia, steadily increases in prevalence with age. If left untreated, AF significantly increases the risk of stroke, heart failure, and death. Despite the increasing prevalence, there are significant research gaps in the prediagnosis symptom experiences of patients with AF. Object...

Background: Patients with atrial fibrillation (AF) commonly transition between care settings and providers. These transitions are often points in the health care system where errors and clinical deterioration can occur. Anticoagulation interruption or discontinuation and sub-optimal follow-up post-emergency department (ED) discharge are considered...

Background: Atrial fibrillation (AF) is a serious heart arrhythmia associated with devastating outcomes such as stroke. Inequitable rural AF care may put patients at risk. Virtually delivered specialty AF care offers a viable option, but stakeholder perceptions of this option within the context of rural AF care is unknown. The study purpose was to...

Objectives: Considerable evidence has advanced the role of citizen-led coalitions (CLC) in supporting the health and social needs of rural citizens. There has been little research focusing on the experiences and strategies of coalitions, with their limited resources and status, in targeting health inequities in their rural communities. The aim of...

Background: In 2010, the Canadian Cardiovascular Society Atrial Fibrillation/Atrial Flutter (AF/AFL) quality indicator (QI) working group was established to develop QIs and assess feasibility of measurement. After extensive review, 3 priority QIs were selected. However, none were measurable at a national level. Methods: The working group reconve...

Background: Atrial fibrillation, the most common arrhythmia worldwide, continues to increase as the population ages. Patients with atrial fibrillation, particularly those newly diagnosed or who have multiple comorbidities, have high healthcare utilisation rates. Nurse-led atrial fibrillation clinics have developed to improve care and guidance for...

Background: Mental health is a major health concern in Canada. As the population ages, adults aged 50 and over will represent a larger proportion of Canadians with mental health concerns. This population is also increasing in size in rural areas; yet, there is a paucity of literature regarding the experiences of older adults with mental health conc...

Objectives: The aim was to identify the best practices of formal new graduate nurse transition programs. This information would be useful for organizations in their support and development of formal transition programs for newly hired nurses. Design: An integrative review of the nursing research literature (2000-2018). Data sources: The litera...

BACKGROUND: The prevalence of atrial fibrillation (AF) is increasing in sub-Saharan Africa and contributes to significant morbidity and mortality from stroke and other cardiovascular diseases. Case finding in some areas of the country, such as in rural Zambia is especially challenging with limited availability of ambulatory electrocardiogram monito...

Introduction: Telehealth is an important tool for ensuring accessible healthcare access particularly over geographical distances. Videoconference and telephone are two common telehealth modalities, yet little is known as to the relative advantage of these modalities. Synthesizing evidence as to the impact of these modalities is important to optimi...

Introduction Hypertension is a longstanding problem in Zambia, yet little is known about its prevalence and risk factors, particularly in rural and urban settings. Identifying geographical variations in hypertension is important to enhance the health of adult Zambians regardless of where they live. Therefore, the purpose of this study was to compar...

Older adults with atrial fibrillation (AF) in rural communities have less access to cardiac specialty care. Telehealth offers a viable approach to provide cardiac care, yet little is known about patients’ and providers’ views on telehealth’s potential to support rural patients with AF. This qualitative descriptive study examines patient and health...

Objective: The virtual delivery of patient education and other forms of telehealth have been proposed as alternatives to providing needed care for patients with chronic diseases. The purpose of this systematic review was to compare the efficacy of virtual education delivery on patient outcomes compared with usual care. Methods: The review examin...

The risk of becoming frail increases with advancing age. One million Canadians are frail, placing them at greater risk for disease and disability. Frailty is easily observed yet difficult for clinicians to define. No gold-standard definition exists, but most clinicians support frailty as a medical syndrome characterized as a state of mild to severe...