ONLINE BULLETIN BOARD SYSTEMS: AN EFFECTIVE RESOURCE FOR GEROPSYCHIATRIC NURSES WORKING IN LONG-TERM CARE? by Selena Marie Santi B.A., McMaster University, 2000 THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in the Program of Gerontology O Selena Marie Santi 2002 SIMON FRASER UNIVERSITY November 2002 All rights reserved. This work may not be reproduced in whole or in part, by photocopy or other means, without permission of the author. APPROVAL Name: Selena Marie Santi Degree: MASTER OF ARTS (GERONTOLOGY) Title of Thesis: Online Bulletin Board Systems: An Effective Resource for Geropsychiatric Nurses Working in Long-Term Care? Examining Committee: Chair: Dr. Habib Chaudhury, Assistant Professor, Gerontology Program, SFU Dr. Andrew Wister, Professor, Gerontology Program, SFU Senior Supervisor DryAssistant Professor, Gerontology Program, SFU Examining Committee Member Dr. Barbara Mitchell, Associate Professor, Gerontology Program, SFU Exaqining Committee Member ssor, School of Nursing, UBC PARTIAL COPYRIGHT LICENCE I hereby grant to Simon Fraser University the right to lend my thesis or project (the title of which is shown below) to users of the Simon Fraser University Library, and to make partial or single copies only for such users or in response to a request from the library of any other university, or other request from the library of any other university, or other educational institution, on its own behalf or for one of its users. I further agree that permission for multiple copying of this work for scholarly purposes may be granted by me or the Dean of Graduate Studies. It is understood that copying or publication of the work for financial gain shall not be allowed without my written permission. Title of Thesis: Online Bulletin Board Systems: An Effective Resource for Geropsychiatric Nurses Working in Long-Term Care? Author: -- - _. - . , ... ,". -. -- -- - Selena arid Santi ABSTRACT As Canada's population ages and the healthcare system undergoes reform, increasing demand is placed on registered nurses working in long-term care (LTC) to provide care to seniors with complicated cognitive and behavioural needs. Although the field of geriatric nursing has expanded with the growth of the senior's population, few nurses feel that they have sufficient information and support to provide adequate care to this population. The goal of this study is to determine whether an Online Bulletin Board System (BBS) is an effective means of meeting nurses' needs for information, networking and support. Meeting these needs is also expected to result in increased perceived levels of care provision efficacy and job satisfaction. A multi-phase sampling frame was used to recruit participants nationwide. In total, the sample was comprised of 42 participants (17 control group participants and 25 intervention group participants). The intervention consisted of providing nurses with access to an Online BBS over a four-and-a-half month period. The Online BBS was designed to allow nurses to share geropsychiatric based information and network with each other in a supportive environment. Data was collected through a pretest and posttest questionnaire, as well as from postings and responses made to the Online BBS. Repeated measures analyses was used to test the effectiveness of the Online BBS on four dependent variables. Results suggest that the Online BBS had a positive effect on reducing the frequency of information needs while increasing nurses' sense of perceived care provision efficacy. Implications for this study are far reaching especially as they relate to the organization of work-related support and resources. The expansion and hture use of the Online BBS for other nurses and healthcare professionals will be dependent on the outcome of this study. ACKNOWLEDGEMENTS There are a number of people whom I would like to thank for supporting me throughout my Master's Degree. First, I would like to thank my committee members, Andrew Wister, Norm OYRourke,and Barbara Mitchell for sharing their valuable expertise and advice. You have each contributed to my development and confidence in research, writing, and analytic skills. I would also like to thank the GPEP team for their encouragement, support and enthusiasm towards my thesis. Specifically, I would like to thank Joan Hibbard, Lisa McFarling, and Ilse Patterson for their guidance and help. There are a number of colleagues who have shared their ideas, expertise and friendship. You have made the past three years rewarding and enjoyable. Specifically, I would like to thank Margot McWhirter, Michele Assaly, Judith Balfour, Tammy Uppenborn, and Mary Rogers. I would also like to thank my friends in Ontario for their continued love throughout the years. Mom, Dad, Jay, and family thank you for the love and support you have given me. I guess when you ask me how my thesis is going I can finally answer in the affirmative. Thanks for supporting me in my decision to move across the country and for providing me with the foundation for fulfilling my dreams, goals, and ambitions. Lastly, I would like to thank Anthony for his unending friendship and love. Thank you for always challenging me, inspiring me, and believing in me. You have truly helped me to climb to greater heights (I'm more machine than man). This journey would not have been the same without you. I can't wait to see what's next! TABLE OF CONTENTS .. APPROVAL ii .......................................................................................... ... ABSTRACT .......................................................................................... iii ACKNOWLEDGEMENTS......................................................................... ...v LIST OF TABLES .................................................................................. viii LIST OF FIGURES ................................................................................... ix LIST OF APPENDICES............................................................................. x Chapter 1: Introduction ................................................................................................... 1 1.1 Background ............................................................................................................. 1 1.2 Lack of Gerontology and Geriatric Mental Health Information in Nursing Education Curricula ................................................................................................ 3 1.3 Web-based Computer Assisted Instruction and Online BBS ................................. 4 1.4 Overview and Rationale .......................................................................................... 6 Chapter 2: Literature Review .......................................................................................... 8 2.1 Theoretical Framework: A Focus on Adult Learning Theory ................................ 8 2.2 Online Virtual Communities and Networks ......................................................... 10 2.3 Online Continuing Nursing Education: The Current Situation............................. 11 2.4 The Development of an Integrated Model ............................................................ 17 2.4.1 A Comparative Approach to Adult Learning Theory and Internet-Assisted Instruction ...... 17 2.4.2 Adult Internet-Assisted Instruction: An Integrated Model ................................................... 20 2.5 Hypotheses ............................................................................................................ 21 Chapter 3: Methodology................................................................................................. 26 3.1 Research Design .................................................................................................... 26 3.2 Sampling Requirements. Procedures and Characteristics ..................................... 28 3.2.1 Sampling Requirements/Group Assignment......................................................................... 28 3.2.2 Sampling Procedures ............................................................................................................ 30 3.2.3 HistoryPolitical Context ......................................................................................................35 3.2.4 Sample Characteristics.......................................................................................................... 38 3.3 Identification of Key Variables ............................................................................. 41 3.3.1 Independent Variable ............................................................................................................ 41 3.3.2 Dependent Variables ............................................................................................................ 41 3.3.3 Prospective Covariates.......................................................................................................... 42 3.4 Measurements ....................................................................................................... 43 3.4.1 Part A: Information Needs .................................................................................................... 43 3.4.2 Part B: Information Resources.............................................................................................. 45 3.4.3 Part C: Care Provision Efficacy ............................................................................................ 46 3.4.4 Part D: Networking & Support ............................................................................................