This position has a term length of 3 years.

Location - North campus. This role is hybrid with a mix of remote and in person

Position sumary

The goal of the Principal Investigator’s program of research is to enhance knowledge about use of quality of life assessment and promote equitable person-centred care, in order to improve services for people living at home with chronic and life-limiting illnesses, particularly kidney failure. The postdoctoral fellowship – employee position will be funded by a 3-year grant. 

Depressive symptoms are very common among people receiving life-saving dialysis for kidney failure. But depression is rarely addressed or treated in dialysis care. One promising solution is cognitive behavioural therapy (CBT), which focuses on improving coping skills and changing negative thoughts and feelings. We know CBT is helpful and possible. But how does it work in dialysis care? Why does it help some, but not all people? Who benefits the most? For dialysis programs to move towards making this solution available to patients, it is important to answer these questions. 

Our overarching goal in this realist study is to evaluate and explain how, why, for whom and in what circumstances CBT works in order to provide equitable people-centred mental healthcare to people with depressive symptoms receiving dialysis. To achieve this goal, we will develop, test and refine a programme theory (a logic that explains how, why, for whom, and in what circumstances a program is expected to work) by answering the following research questions:

1 How is CBT intended to work?

2 What are the different types of depressive symptom trajectories and related patient-reported outcomes, social determinants of health (SDOH), healthcare interventions and health-related variables for people receiving dialysis?

3 How does CBT work to improve depressive symptoms for people receiving dialysis?

4 Why, for whom, in what circumstances does CBT work?

The research team will review previous studies, interview CBT therapists, and study the diverse backgrounds, health and life experiences of 1070 people receiving dialysis. Then we will then invite 100 of these people with different characteristics to engage in therapist guided remotely-delivered CBT. We will interview these patients and their therapists. We will use all of this data to answer how, why, for whom, and in what conditions CBT works best.

This research will address a major gap in mental healthcare for people receiving dialysis. Our results will help us pursue health equity: We will explain how, why, for whom, and in which conditions the best results can be achieved for those who are at highest risk living with dialysis.

This research will be led with people who have lived experience of dialysis, as well as dialysis clinicians and administrators, an industry partner, equity and CBT experts. Together, the findings will guide dialysis programs towards successfully offering CBT as a solution for addressing this gap in mental healthcare for all.

Applicants who are interested in this project may also apply for the Research Associate position that is being advertised. Both are based in the Faculty of Nursing.

Duties

• Prepare the study protocol, including detailed objectives.
• Support the project coordinator with ethics applications at various organizations and amendments in 3 provinces.
• Plan and perform the realist synthesis: Define scope of realist synthesis, in consultation with team leads and library services; review and summarize literature; interview CBT therapists as a part of the realist synthesis and prior to the intervention; co-lead the seven steps to develop the realist synthesis; support the development of the initial programme theory (IPT).
• Plan and perform the realist evaluation: Collect qualitative data: interviews and focus groups with patients after they received CBT, as well as with the therapists involved; support mixed methods analyses guided by a realist approach which involves iteratively implementing different analytic approaches to test context-mechanism-outcome configurations in the IPT using diverse data sources; co-develop the final programme theory.
• Qualitative and mixed methods data analysis.
• Support patient recruitment if needed.
• Support the planning and execution of the economic cost analysis.
• Oversee data management life cycle of the project.
• Lead and/or assist in the preparation of research publications.

Minimum Qualifications

The successful candidate will have excellent organizational, time management and communications skills (oral and written). The ideal candidate will have high-level interpersonal skills and advanced organization, decision making, critical thinking and problem-solving skills. A proven ability to work in a fast-paced research environment and meeting tight deadlines will ensure success in this position. Familiarity with university policies and procedures and previous work experience in an academic/clinical research setting (especially kidney care) are an asset.

• A PhD in a Health or Social Sciences discipline is required and essential for this position
• Knowledge of and/or experience in realist synthesis and/or realist evaluation is required
• Demonstrated superior written communication abilities, e.g., manuscripts, reports, briefings, grant proposal writing
• Demonstrated superior project planning and management skills
• Demonstrated superior communications and interpersonal skills
• Excellent organizational and time-management skills with the ability to adapt to competing timelines and change
• Accuracy and attention to detail
• Ability to work both independently and in a team environment
• Excellent initiative and ability to work with limited supervision
• Must have superior skills in MS Office suite of programs
• Experience with different analysis software such as NVIVO and SPSS

Preferred Qualifications

• Experience in guiding and coaching undergraduate and graduate students is an asset
• Experience with research in quality of life research, patient-reported outcomes, patient-oriented research, kidney care, and mental health is an asset.