Publications by authors named "David B Nicholas"
Impacts of the COVID-19 Pandemic on Chronic Kidney Disease Care: Perspectives of Health Care Providers.
Can J Kidney Health Dis
July 2025
Background: The COVID-19 pandemic significantly disrupted health care delivery; however, limited research attention has addressed the impacts of the pandemic specifically on renal-based health care.
Objective: The aim of the study was to understand the health and psychosocial impacts of the COVID-19 pandemic on care delivery as well as on health care providers (HCPs).
Design: A qualitative Interpretive Description approach was used.
'It's Really Who They Are and What They Want': Staff Perspectives on Supporting Autonomy for Autistic Adults With Intellectual Disabilities.
J Appl Res Intellect Disabil
July 2025
Background: Autonomy is a crucial component of self-determination, yet it is limited for Autistic individuals, especially those with co-occurring intellectual disabilities. We explored how professionals supported Autistic people with intellectual disabilities' autonomy.
Materials And Methods: This qualitative study used a community-based participatory approach.
As the number of older autistic adults and adults with intellectual disabilities grows, expanding capacity to meet their needs is crucial. On November 23-25, 2023, a Think Tank on aging in autism and/or intellectual disabilities was convened, with national and international delegates within this field. The Think Tank consisted of presentations focusing on key issues as well as a series of panel presentations addressing first-person lived experience, family caregiving, service provision in the community, and physical and mental health-based care.
View Article and Find Full Text PDFIntroduction: In this qualitative study, care providers from long-term care homes were interviewed to explore how they experienced, coped with, and adapted to care shifts during the COVID-19 pandemic.
Methods: Thirteen multidisciplinary care providers and 24 supervisory and administrative staff participated in either a focus group or individual interview between July 2021 and February 2022. Participants were front-line care providers in 5 urban long-term care homes in western Canada.
Background: There has been limited research examining the perspectives of children and youth receiving protective services during the COVID-19 pandemic, despite reported challenges of unmet support needs due to reduced services.
Objective: The purpose of this study was to elicit experiences in navigating the COVID-19 pandemic from the perspective of youth receiving child/youth protection and advocacy services, and that of their supporters/advocates. Participants were invited to reflect on their experiences in the pandemic and offer recommendations for better supporting youth during a pandemic.
As part of a participatory project to advance navigational service delivery systems for children with neurodevelopmental disability (NDD) and their families, this paper addresses proceedings from a capacity-building conference in Vancouver, Canada. A total of 29 invited key stakeholders attended the meeting with the following aims: knowledge sharing amongst provincial/territorial regions advancing NDD navigation capacity; sustainable action-oriented knowledge exchange; and operationalizing next steps to build navigation resources across Canadian regions. Regional representation included multiple and inter-sectoral partners (e.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates how the COVID-19 pandemic has affected autistic children, their families, and the service providers who support them, revealing a lack of understanding in this area.
- Through interviews with 13 parents and 18 service providers, the research highlights various challenges brought on by pandemic restrictions, which negatively impacted the daily lives of autistic individuals and their support systems.
- The findings emphasize the importance of enhancing autism-specific support and preparedness in services to better handle similar emergencies in the future and inform post-pandemic service delivery.
Article Synopsis
- * Researchers studied how to support these young adults by working with autistic community partners and listening to their experiences.
- * Participants said being independent means being true to themselves and highlighted three important supports: having choices, communicating in their own way, and feeling safe.
The COVID-19 pandemic imposed widespread impacts on the health and well-being of children with respiratory challenges and their families, as well as on the health care system that supports them. An exploratory qualitative study was undertaken to examine how the pandemic impacted families' and health care providers' daily lives and experiences of care. Four youth, 12 parents and 7 health care providers participated in interviews via telephone or online technology.
View Article and Find Full Text PDFArticle Synopsis
- A study involving 33 autistic adults revealed their experiences in two industry-led employment programs designed to support their transition into the workplace.* -
- The analysis identified five key themes, including the evolution of job tasks, the diversity of workplace relationships, changing needs for support, the development of a professional identity, and the importance of creating supportive environments.* -
- The research ultimately led to the development of a new model that illustrates both individual and workplace factors that influence the experiences of autistic individuals in these employment programs.*
Facilitators and barriers in psychotherapy from the perspective of autistic adults: an enhanced critical incident study.
Int J Qual Stud Health Well-being
December 2023
Article Synopsis
- - A study was conducted to explore the therapy needs and preferences of autistic adults facing mental health challenges, highlighting the incomplete literature on the subject.
- - Eight autistic adults participated in interviews using the Enhanced Critical Incident Technique, resulting in 147 identified incidents that affect therapeutic practice, including trust, individualized care, and family involvement.
- - The research concluded that while therapy for autistic adults shares similarities with non-autistic adults, it requires specific knowledge about autism to improve care delivery, emphasizing the importance of incorporating insights from autistic individuals.
Article Synopsis
- The study explores the effects of the COVID-19 pandemic on families who lost children under 18 with chronic life-limiting conditions during the pandemic.
- Interviews were conducted with 20 bereaved parents to understand changes in end-of-life care and their grieving process due to the pandemic.
- Results showed heightened anxiety about children's health, challenges in navigating public health measures, and the importance of strong support networks in coping with loss.
Article Synopsis
- Autistic adults often face higher rates of mental health issues, and while psychotherapy is seen as a suitable treatment, there's limited evidence supporting its effectiveness.
- Researchers interviewed 13 mental health providers using the Enhanced Critical Incident Technique to gather insights on their experiences providing therapy to autistic adults.
- The study identifies both the challenges faced in therapy for autistic individuals and the strategies providers use to enhance the therapeutic experience, along with practice recommendations and directions for future research.
Article Synopsis
- - The COVID-19 pandemic forced mental health services to rapidly change how they operated, moving from in-person visits to mostly virtual ones to comply with public health guidelines.
- - A study involving 98 mental health providers focused on their experiences between March and June 2020, revealing key challenges like the transition to remote work, worries about in-person interactions, and increased exhaustion due to pandemic-related pressures.
- - Insights from this research highlight the importance of understanding and addressing the emotional toll on mental health providers during crises, suggesting the need for better support and feedback systems moving forward.
Examining the COVID-19 pandemic and its impact on social work in health care.
J Soc Work (Lond)
March 2023
Article Synopsis
- This study focuses on the experiences of healthcare social workers during the COVID-19 pandemic, evaluating changes in their practice and the personal/professional challenges they faced.
- It involved 12 focus groups with 67 social workers from various hospitals in western Canada, identifying key themes such as increased workload, communication issues, and emotional distress.
- The findings highlight the need for proactive strategies to support social workers and improve patient care during and after the pandemic.
'My Transplanted Self': Adolescent recipients' experience of post-traumatic growth following thoracic transplantation.
J Heart Lung Transplant
March 2023
Article Synopsis
- This study explores the post-transplant experiences of adolescents who received heart and lung transplants, revealing how these life-saving procedures impact their lives.
- Using semi-structured interviews with 32 participants, the research identifies three key areas of growth: personal strengths, relationships with others, and developing a life philosophy.
- The findings suggest that undergoing transplantation can be a transformative experience for adolescents, highlighting the potential for positive growth, which practitioners should consider in their care approaches.
Mental health challenges during COVID-19: perspectives from parents with children with neurodevelopmental disabilities.
Int J Qual Stud Health Well-being
December 2022
Article Synopsis
- The COVID-19 pandemic created significant challenges for children with neurodevelopmental disorders (NDDs) and their families due to public health restrictions that limited access to necessary services and supports.
- A study involving interviews with 40 caregivers revealed that these measures led to gaps in social support and increased mental health issues for both children and parents.
- Recommendations include adopting a disability-inclusive approach in emergency planning and allocating resources to better support families during and after crises.
Background: The COVID-19 pandemic has had deleterious impacts on pediatric patients and families, as well as the healthcare providers who have attended to their care needs.
Methods: In this qualitative study, children with a cardiac transplant, as well as their families and healthcare providers were interviewed to explore the impact of the COVID-19 pandemic on pediatric care, as well as on patients' and their families' daily lives. Participants were recruited from a children's hospital in western Canada.
Individuals with neuro-developmental disabilities (NDD) have been profoundly affected by the COVID-19 pandemic. Based on focus groups with 24 service providers supporting this population, using an Interpretive Description approach, we examined perceived impacts of the pandemic on individuals with NDD and their families. The results highlight pandemic-related experiences which include: service reduction, the need for financial supports, relying on natural supports, and school-related challenges.
View Article and Find Full Text PDFArticle Synopsis
- The COVID-19 pandemic caused significant disruptions in services for children and youth with neuro-developmental disabilities, leading to service closures and changes in program delivery.
- Focus groups with 24 service providers revealed challenges like increased workloads, burnout, and conflicts, while highlighting a lack of support for self-care.
- Despite these difficulties, there were some positive outcomes, including greater collaboration among organizations and the need for improved capacity building to address existing gaps in service delivery.
Article Synopsis
- - The COVID-19 pandemic significantly affected the mental health of children with health vulnerabilities and their families, as they relied heavily on health and social care systems during this crisis.
- - In-depth interviews with 262 participants, including children, parents, and healthcare providers, revealed feelings of loneliness among children, burnout among parents, and moral distress among healthcare workers, all exacerbated by insufficient resources.
- - The study concluded that there are critical mental health impacts on families and providers due to the pandemic, suggesting the need for targeted mental health support and better preparation for future public health emergencies.
"Realizing the problem wasn't necessarily me": the meaning of childhood adversity and resilience in the lives of autistic adults.
Int J Qual Stud Health Well-being
December 2022
Article Synopsis
- The study investigates the impact of childhood adversity and resilience in autistic young adults, highlighting how these factors affect their health outcomes throughout life.
- Five community members from the autism community helped shape the research, and four autistic individuals participated in interviews to share their experiences.
- Results indicate that adversity negatively affects these individuals, but resilience emerges through specific protective factors, offering insights for improving support for autistic youth.
Article Synopsis
- The study investigates the acceptability of the Work Readiness Inventory (WRI) and a modified Ansell-Casey Life Skills Assessment (ACLSA-M) for measuring employment readiness in youth/young adults on the autism spectrum, as their effectiveness in this group hasn't been previously confirmed.
- By employing a mixed-methods approach that includes quantitative and qualitative assessments, the research found both measures to be broadly acceptable, with slight modifications needed to better suit individual and job-specific requirements.
- The findings suggest that a combination of assessment methods is essential for accurately evaluating employment readiness in this population, considering their lower participation rates in the workforce.