Mary T. Fox

Associate Professor

Locations / Contact Info:

343 Health, Nursing & Environmental Studies - HNES
Keele Campus
Phone: 416 736 2100 Ext. 23088
Fax: 416-736-5714

Email address(es):

maryfox@yorku.ca

Faculty & School/Dept.

Faculty of Health - School of Nursing

Degrees

BScN - 1989
McGill University
Montreal, Quebec

PhD Nursing - 2007
University of Toronto
Toronto, ON

MSc Nursing - 1994
McGill University
Montreal, Quebec

Biography

Bio. Mary Fox RN, PhD is an Associate Professor in the School of Nursing, a prior Ontario Ministry of Health Career Scientist and CIHR fellow and a current Ontario Ministry of Research & Innovation Early Researcher award recipient. Her research contributes to a more comprehensive of function-focused interprofessional interventions to improve outcomes during older adults’ hospitalization. Her expertise includes qualitative and quantitative data analysis; systematic reviews; survey and intervention research; bedrest; and the Acute Care for Elders (ACE) model.

Selected Publications


Papers in peer reviewed journals




Sidani, S. & Fox, M.  (2014). Patient-Centered Care: Clarification of its Specific Elements. Journal of Interprofessional Care, 28(2), 134-141, doi: 10.3109/13561820.2013.862519 



Fox, M., Persaud, M., Maimets, I., Brooks, D., O’Brien, K., & Tregunno, D. (2013).     Effectiveness of early discharge planning for older adults acutely admitted to hospital: A systematic review, BMC Geriatrics, 13:70, doi:10.1186/1471-2318-13-70.



Fox, M.T., Sidani, S., Persaud, M., Maimets, I., Tregunno, D., & Brooks, D., O’Brien, K. (2013).  Acute Care for Elders (ACE) Components of Acute Geriatric Unit Care: Systematic Descriptive Review.  Journal of the American Geriatrics Society, 61(6), 939 - 946. Published in early view 20may2013 http://onlinelibrary.wiley.com/journal/10.1111/%28ISSN%291532-5415/earlyview\




Fox, M. (2013). Adapting the Acute Care for Elders (ACE) model to your hospital. INvited Guest Editorial, Geriatric Nursing, 34(4), 332-334.





Fox, M.T. (2013). The Acute Care for Elders (ACE) model: Nursing interventions for optimal outcomes. Perspectives, Journal of the Canadian Gerontological Nursing Association, 36(2), 16-17.



Wagner, L.M., Vaughan Dickson, V., Shuluk, J., Richards, J., Fox, M., & Capezuti, E. (2013). Nurses’ Knowledge of Geriatric Nursing Care in Canadian NICHE Hospitals. Perspectives, Journal of the Canadian Gerontological Nursing Association, 36(3), 6-14.


Fox, M., Persaud, M., Maimets, I., O’Brien, K. Brooks, D., Tregunno, D., & Schraa, E. (2012). Effectiveness of acute geriatric unit care using Acute Care for Elders (ACE) components: A systematic review and meta-analysis, Journal of the American Geriatrics Society, 60(12), 2237-2245. doi:http://dx.doi.org/10.1111/jgs.12028


Fox, M.T. & Al-Haj, M. (2012). Complex Continuing Care residents have more sleep complaints after spending most of the week in bed. Perspectives, Journal of the Canadian Gerontological Nursing Association, 35(4), 10-11.


Fox, M.T., Al-Haj, M., & Ko, C. (2012). Why do Complex Continuing Care residents confine themselves to bed?” Perspectives, Journal of the Canadian Gerontological Nursing Association, 35(3), 16-17. 


Fox, M.T., Sidani, S., Streiner, D., McGilton, K.S., & Grady, C. (2011). Effect of the response tree format on the utility and psychometric properties of scales measuring symptoms in adults undergoing in-patient rehabilitation, Research in Nursing & Health, 34(6), 508-519.



Fox, M.T., Sidani, S., & Brooks (2010). Differences in sleep complaints in adults with varying levels of bed days residing in extended care facilities for chronic disease management. Clinical Nursing Research: An International Journal, 19(2), 181-202. 


Fox, M.T. Sidani, S., & Brooks, D. (2010). The relationship between bed rest and sitting orthostatic intolerance in adults residing in chronic care facilities. Journal of Nursing and Healthcare of Chronic Illness, 2(3), 187-196.


Fox, M.T., Sidani, S., & Brooks, D. (2009). Perceptions of bed days for individuals with chronic illness in extended care facilities. Research in Nursing & Health, 32(3), 335-344.



Sidani, S., Miranda, J., Epstein, D., & Fox, M. (2009). Influence of treatment preferences on validity: A review. Canadian Journal of Nursing Research, 41(4), 52-67.



Janes, N.,
Fox, M., Lowe, M., McGilton, K., & Schindell-Martin, L. (2009). Facilitating best practice in aged care: Exploring influential factors through critical incident technique. International Journal of Older People Nursing, 4(3), 166-176.


McGilton, K., Boscart, V., Fox, M., Sidani, S., Rochon, E., & Sorin-Peters, R. (2009). A Systematic Review of the Effectiveness of Communication Interventions for Health Care Providers Caring for Patients in Residential Care Settings. Worldviews on Evidenced-Based Nursing, 6(3), 149-159.


Fox, M. T., Sidani, S., & Streiner, D. (2007). Using standardized survey items with older adults hospitalized for chronic illness. Research in Nursing & Health, 30(4), 468-481.



Summaries in peer-reviewed journals or databases



Tinetti, M. (2013, June 18). Review: Acute geriatric unit care reduces falls, delirium, and functional decline [Review of the article “Effectiveness of acute geriatric unit care using Acute Care for Elders components: A systematic review and meta-analysis”]. ACP Journal Club, 158(12) Annals of Internal Medicine, DOI:10.7326/0003-4819-158-12-201306180-02011


Centre for Reviews and Dissemination. (2013). Effectiveness of acute geriatric unit care using Acute Care for Elders components: A systematic review and meta-analysis [Commentary on the article “Effectiveness of acute geriatric unit care using Acute Care for Elders components: A systematic review and meta-analysis”]. Retrieved from http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?AccessionNumber=12013002774#.UciY_tjU18E


Acute Care for Elders components of acute geriatric unit care: Systematic descriptive review [Review of the article “Acute Care for Elders components: Systematic descriptive review”]. (2013, May 21). Nurse Practitioner. Retrieved from http://www.mdlinx.com/nurse-practitioner/news-article.cfm/4632950


KT+ Knowledge Translation. (2013). Acute Care for Elders components of acute geriatric unit care: Systematic descriptive review [Review of the article “Acute Care for Elders components of acute geriatric unit care: Systematic descriptive review”]. Retrieved from http://plus.mcmaster.ca/KT/QuickSearch.aspx


Effectiveness of early discharge planning for older adults acutely admitted to hospital: A systematic review [Review of the article “Effectiveness of early discharge planning for older adults acutely admitted to hospital: A systematic review”]. (2013, July 8). Nurse Practitioner. Retrieved from http://www.mdlinx.com/emergency-medicine/news-article.cfm/4715760



 


 



 

Other Research Outputs

INTERVIEWS & PRESS RELEASES

Trudel, Kevin. (Nov 28, 2012). Older zoomers receive better hospital care in specialized units. Zoomer radio. Retrieved from http://www.zoomerradio.ca/news/latest-news/older-zoomers-receive-better-hospital-care-in-special-units/.

McLean, Sandra. (Nov 28, 2012). Seniors fare better in acute geriatric units with function focused approach. YFile. Retrieved from http://yfile.news.yorku.ca/2012/11/27/seniors-fare-better-in-acute-geriatric-care-units-with-function-focused-approach/

Heron, R. (Nov 28, 2012). Function-focused care creates better outcomes for hospitalized seniors: York U study. Press Release. Retrieved from http://news.yorku.ca/2012/11/28/function-focused-care-creates-better-outcomes-for-hospitalized-seniors-york-u-study/

No author. (Apr 9, 2011). ACE model retreat day. York Central Hospital’s Newsletter.

McLean, S. (Apr 11, 2011). Specialized seniors care delivers best outcomes in hospitals. YFile. Retrieved from http://yfile.news.yorku.ca/2011/04/11/specialized-senior-care-delivers-best-outcomes-in-hospitals/

No author. (2008, May 12).  It’s Canadian Nursing Week and York has two great reasons to celebrate. YFile. Retrieved from http://yfile.news.yorku.ca/2008/05/12/its-canadian-nursing-week-and-york-has-two-great-reasons-to-celebrate/

The Canadian Health Services Research Foundation (2005, Summer). Collaborative relationships the root of research program. Knowledge brokering and the collaborative research program. Links – Newsletter of the Canadian Health Services Research Foundation, 8(2), p. 10. Retrieved from http://www.chsrf.ca/Migrated/PDF/Links/v8n2_e.pdf

 

 

 

Affiliations

Canadian Assoication on Gerontology
Member

College of Nurses of Ontario
Member

Canadian Gerontological Nursing Assoication
Member

Nursing Leadership Network of Ontario
Member

Gerontological Society of America
Member

Rehabilitation Nurses of Ontario
Member

Nursing Research Interest Group of Ontario
Member

Service/Community Activities

Faculty of Health Research and Awards Committee
Member

Graceful Aging Alliance & Steering Committee
Chair, 2009-2010

Graceful Aging Steering Committee
Founding member

http://

Awards

CIHR Fellowship - 2004

Dorothy M. Pringle Award for Excellence in Research - 2008

Career Scientist Award - 2008

Early Researcher Award, Faculty of Health, York University - 2011

2010 Top Reviewer Award, Research in Nursing & Health - 2011

Early Researcher Award - 2014

Supervision

Currently available to supervise graduate students: Yes

Currently taking on work-study students, Graduate Assistants or Volunteers: Yes

Available to supervise undergraduate thesis projects: No

Current Research

My current research focuses on developing, evaluating, and translating interprofessional interventions to improve outcomes during older adults’ hospitalization.

Research Projects

Insomnia and cardiovascular diseases: Influence of behavioural treatments and preferences
Research has shown that persons who have trouble sleeping and experience stress are at risk of developing heart diseases and high blood pressure. Two treatments, called stimulus control instructions and sleep efficiency treatment, that do not involve sleeping pills, have been found effective in managing trouble sleeping. This study aims to find out if the two treatments are effective in improving sleep and reducing stress and the risk of heart diseases and high blood pressure. Persons with trouble sleeping may have a preference for either treatment. It is believed that if persons get the treatment they prefer, then they are satisfied with the treatment and adhere to it, and experience improvement in their sleep. This study will also examine the extent to which giving persons the treatment of their choice, as compared to giving persons treatment based on chance, will lead to higher satisfaction and compliance with treatment, and greater improvement in sleep. About 300 persons who experience trouble sleeping will be included in the study. They will be requested to complete a questionnaire and a sleep diary before and after they receive treatment, as well as 6 and 12 months later.
Role: CoInvestigator
Amount funded: $500000
Year Funded: 2009
Funded by: Canadian Institutes of Health Research
Other funding: Cardiovascular and respiratory diseases operatin grant

Limited physical activity and bed rest in seniors with complex chronic disease
This grant focuses on identifying research priorities to prevent decreased mobility in older persons with CCD following an acute illness episode. The meetings will be conducted in two phases. In Phase 1 we will identify research priorities to prevent decreased mobility following an acute illness episode in this population. In Phase II, we will develop a research action plan which jointly addresses gaps in the knowledge and stakeholder information needs, and forge new partnerships for the future projects. Outcomes include: an action plan outlining future research initiatives which are relevant to stakeholders' information needs and represent a gap in evidence in this area.
Role: Principal Investigator
Amount funded: $10000
Year Funded: 2008
Funded by: Canadian Institutes of Health Research
Other funding: N/A

Nurse and organizational readiness to deliver best elder care: The key to Ontario’s ability to design and implement Senior Friendly Hospital plans
Many provincial health authorities committed to developing Senior Friendly Hospitals after improved outcomes were identified when older adults received services based on the Acute Care for Elders (ACE) model of service delivery. The ACE model speaks to the unique and central role of nurses, yet little is known about nurses’ capacity to provide best elder care. The goal of this project is to better understand nurses’ needs to provide best elder care. The project will examine the relationships between organizational (team collaboration, geriatric resources, and leadership support) and nurse (skill and knowledge in geriatric nursing and patient & family centred-care, and ACE role agreement) characteristics, nurse outcomes (role clarity, job satisfaction and turnover intentions), and nurses’ perspectives on best elder care. We will ask up to 3615 nurses to complete relevant surveys, and up to 80 nurses participate in focus groups to further our understanding of their needs and to identify strategies to help nurses provide best elder care. This project is critical to the success of Senior Friendly Hospital initiatives. It will provide information that decision-makers in provincial health authorities can use to enhance nurses’ ability to ensure that older adults have good health and discharge outcomes during hospitalization.
Role: Principal Investigator
Amount funded: $200000
Year Funded: 2011
Funded by: Ontario Ministry of Health and Long-Term Care

Phase 1 of an early rehabilitation intervention for older adults with complex chronic disease
Intense physical activity is often undesirable and unacceptable to older adults experiencing an acute illness or exacerbation of a chronic condition. Yet, inactivity in the form of bed rest is has many known adverse health consequences. To address this issue, we are developing 2 low intensity exercise programs with input from older adults. We are evaluating older hospitalized adults opinions about the programs. The results will be used to refine the interventions, clarify patient characteristics on which to tailor the interventions and define the required resources prior to testing their effects in a future clinical trial.
Role: Principal Investigator
Amount funded: $50000
Year Funded: 2009
Funded by: Canadian Institutes of Health Research
Other funding: N/A

Systematic review of acute hospital geriatric intervention units
Specialized geriatric services have been designed to prevent the complications of hospitalization for acutely ill older adults with complex chronic disease. In this review we are examining all of the information that has been written about these services. We are describing the activities that are delivered in each service, and we are evaluating which services are best at preventing complications for older adults.
Role: Principal Investigator
Amount funded: $100000
Year Funded: 2009
Funded by: Canadian Institutes of Health Research
Other funding: N/A

The forgotten component of care quality: An exploration of nursing process
Although nursing-sensitive outcomes have been identified and are being monitored in the Health Outcomes for Better Information and Care (HOBIC) initiative, there is limited knowledge of the evidence-based interventions that nurses implement to achieve these outcomes. This study extends the HOBIC initiative by delineating the processes of care, operationalized in evidence-based interventions, performed by regulated nursing staff, that contribute to outcomes. This study will specifically: 1) identify the processes comprising nursing practice that contribute to patient outcomes monitored in the HOBIC initiative; 2) develop instruments to capture the identified processes of nursing and (3) tests the psychometric properties of the instruments.
Role: CoInvestigator
Amount funded: $2000000
Year Funded: 2009
Funded by: Ontario Ministry of Health and Long-Term Care
Other funding: N/A

Validating a response format to facilitate responding in older adults
This study evaluates if a response tree maintains the psychometric properties in, and improves older hospitalized adults' responding to, several standardized surveys measuring symptoms of orthostatic hypotension, fatigue, and sleep quality. The results will: 1) provide data validating the use of the revised scales; and, 2) have implications for how other self-report scales are designed for use with older hospitalized adults. These are important considerations since the data generated from such surveys are used all the time for evaluation, accountability and quality improvement purposes (e.g. Hospital Report Card and Patient Satisfaction Surveys).
Role: Principal Investigator
Amount funded: $48000
Year Funded: 2007
Funded by: Canadian Institutes of Health Research
Other funding: N/A