BackgroundThere are calls for better application of theory in health services research. Research exploring knowledge translation and interprofessional collaboration are two examples, and in both areas, complexity theory has been identified as potentially useful. However, how best to conceptualize and operationalize complexity theory in health services research is uncertain. The purpose of this scoping review was to explore how complexity theory has been incorporated in health services research focused on allied health, medicine, and nursing in order to offer guidance for future application. Given the extensiveness of how complexity theory could be conceptualized and ultimately operationalized within health services research, a scoping review of complexity theory in health services research is warranted.MethodsA scoping review of published research in English was conducted using CINAHL, EMBASE, Medline, Cochrane, and Web of Science databases. We searched terms synonymous with complexity theory.ResultsWe included 44 studies in this review: 27 were qualitative, 14 were quantitative, and 3 were mixed methods. Case study was the most common method. Long-term care was the most studied setting. The majority of research was exploratory and focused on relationships between health care workers. Authors most commonly used complexity theory as a conceptual framework for their study. Authors described complexity theory in their research in a variety of ways. The most common attributes of complexity theory used in health services research included relationships, self-organization, and diversity. A common theme across descriptions of complexity theory is that authors incorporate aspects of the theory related to how diverse relationships and communication between individuals in a system can influence change.ConclusionComplexity theory is incorporated in many ways across a variety of research designs to explore a multitude of phenomena.. Although complexity theory shows promise in health services research, particularly related to relationships and interactions, conceptual confusion and inconsistent application hinders the operationalization of this potentially important perspective. Generalizability from studies that incorporate complexity theory is, therefore, difficult. Heterogeneous conceptualization and operationalization of complexity theory in health services research suggests there is no universally agreed upon approach of how to use this theory in health services research. Future research should include clear definitions and descriptions of complexity and how it was used in studies. Clear reporting will aid in determining how best to use complexity theory in health services research.

Compassion fatigue (CF) is a combination of secondary traumatic stress and burnout. Empathy becomes depleted among professional caregivers due to repeated exposure to emotional pain. Negative effects include decreased general wellbeing, impaired caregiver health and diminished team functioning. Intervention is needed to support caregiver quality of life and team relationships in high-stress work environments. This pilot study evaluated the impact of a pilot CF resiliency (CFR) programme on interprofessional staff at a regional cancer centre. An embedded experimental mixed-methods design was employed to evaluate a 6-week formalised CFR intervention. We measured CF satisfaction, burnout, clinical stress and silencing responses pre- and post-intervention. Focus group and individual interviews were conducted mid-programme and at end-programme completion to understand participants' views about how the programme affected their experiences of CF. Qualitative and quantitative data were analysed separately and merged to produce the overall findings. Participants reported reduced clinical stress at programme completion (t = 3.5; p = .005). This finding may be explained by participants' ability to identify signs and symptoms of CF and engage in self-care and mindfulness activities. Further larger studies are needed to evaluate the long-term effects of CFR programmes on caregiver and organisational wellbeing.

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Findings suggest that assessment of sleep quality should be an essential component of diabetes care. Understanding sleep practices may aid public health practitioners and other healthcare providers in the design of culturally appropriate interventions to improve sleep quality in persons with DMT2.

AbstractIn 2011, there was an expected shortage of 200 full-time faculty. While there are an estimated 322 graduate students in Nurse Practitioner and Masters/PhD programs in Canada today, the supply of potential new faculty falls short of the anticipated demand in the years ahead (Canadian Association of Schools of Nursing). This mixed method study explored how organizational culture and the perceived level of psychological and structural empowerment are associated with one’s work environment among Canadian nursing faculty and to explore the state of mentorship in schools of nursing.