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Jehloh L, Songwathana P, Kitrungrote L, Bourbonnais A. Perspectives of family caregivers and nurses on hospital discharge transitional care for Muslim older adults living with COPD: a qualitative study. BMC Nurs 2024; 23:273. [PMID: 38659051 PMCID: PMC11044287 DOI: 10.1186/s12912-024-01943-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND The increased number of emergency department visits among older adults living with chronic obstructive pulmonary disease reflects the challenges of hospital discharge transition, especially in those from a cultural minority. The barriers and facilitators of this discharge from the perspective of formal and informal care providers, such as nurses and family caregivers, are important to identify to provide effective symptom management and quality of care. The purpose of this study was to describe the barriers and facilitators in caring for Muslim older adults with chronic obstructive pulmonary disease (COPD) during hospital discharge transitional care. METHODS A descriptive qualitative study was conducted in a hospital of Thailand where Muslim people are a cultural minority. Thirteen family caregivers of Muslim older adults living with COPD and seven nurses were purposively recruited and participated in semi-structured interviews and focus group discussions. Content analysis was used to analyze the data. RESULTS Five barriers and three facilitating factors of transitional care for Muslim older adults living with COPD were outlined. Barriers included: (1) lack of knowledge about the causes and management of dyspnea, (2) inadequate discharge preparation, (3) language barrier, (4) discontinuity of care, and (5) COVID-19 epidemic. Facilitators included: (1) the ability to understand Malayu language, (2) the presence of healthcare professionals of the same gender, and (3) the presence of Muslim healthcare providers. CONCLUSION Family caregivers require more supportive care to meet the care needs of Muslim older adults living with COPD. Alternative nurse-based transitional care programs for these older adult caregivers should be developed.
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Affiliation(s)
- Latifah Jehloh
- Faculty of Nursing, Prince of Narathiwas University, Muang, Narathiwat, Thailand
| | - Praneed Songwathana
- Faculty of Nursing, Prince of Songkla University, Hatyai, Songkhla, Thailand.
| | - Luppana Kitrungrote
- Faculty of Nursing, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada
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Auclair I, Bourbonnais A. The Involvement of Caregivers in the End-of-life Care of an Older Adult Living in a Long-term Care Home: A Qualitative Case Study with Nurses and Relatives. Can J Nurs Res 2024:8445621241247862. [PMID: 38619920 DOI: 10.1177/08445621241247862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND A key role of nurses working in long-term care homes (LTCHs) is to promote the involvement of care partners in end-of-life (EOL) care. However, studies on the involvement of care partners in EOL care in LTCHs have focused on care planning and decision-making. While care partners can participate in other ways, it's unclear how they are currently involved in EOL care by staff. PURPOSE We aimed to explore the involvement of care partners in the EOL care of an older adult living in a LTCH. METHODS A qualitative case study was conducted. Data was collected from a sample of four nurses and three care partners, using sociodemographic questionnaires, individual semi-structured interviews, documents pertaining to the LTCH's philosophy for EOL care, and a field diary. RESULTS The results of a thematic analysis showed the broad scope of care partners' possible involvement, including contributing to care, obtaining information, and being present. As there was some variation in care partners' desire to be involved, nurses seemed to rely on them to convey their wishes. To promote this involvement, some strategies aimed at health professionals and managers were suggested. CONCLUSIONS These results can guide improvement in clinical practices and raise awareness on the EOL care experiences of care partners.
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Affiliation(s)
- Isabelle Auclair
- PhD candidate, Faculty of Nursing, Université de Montréal, Montreal, Canada
- Research assistant, Research Centre of the Institut universitaire de gériatrie de Montréal, Montreal, Canda
| | - Anne Bourbonnais
- Full professor, Faculty of Nursing, Université de Montréal, Montreal, Canada
- Researcher, Research Centre of the Institut universitaire de gériatrie de Montréal, Montreal, Canada
- Chairholder of the Canada Research Chair in Care for Older People Chairholder of the Research Chair in Nursing Care for Older People and their Families, Montreal, Canada
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Bourbonnais A, Lachance G, Baumbusch J, Hsu A, Daneau S, Macaulay S. At the Epicentre of the COVID-19 Pandemic in Canada: Experiences and Recommendations of Family Care Partners of an Older Person Living in a Long-Term Care Home. Can J Aging 2023:1-13. [PMID: 37771136 DOI: 10.1017/s0714980823000466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
The roles of family care partners of older persons living in long-term care homes (LTCH) were severely disrupted during the coronavirus disease (COVID-19) pandemic. Our aim was to describe their experiences and to solicit their recommendations for supportive actions. We conducted a critical ethnography with 24 care partners who cared or had cared for an older person living in an LTCH in Québec during the COVID-19 pandemic. We collected data during interviews and used Spradley's method to analyse them. Care partners experienced a forced separation from the older persons they cared for, which resulted in significant distress. Care, including post-mortem care, was considered inadequate and sometimes even inhumane. Communication was inconsistent, and this variability was also noted in visitation rules. Care partners perceived LTCHs as a neglected community. Supportive actions were recommended. The results illustrated the essential contribution of care partners, and the supportive actions they recommended must be a catalyst for change toward more humane care in LTCH settings.
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Affiliation(s)
- Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Geneviève Lachance
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jennifer Baumbusch
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Amy Hsu
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Stéphanie Daneau
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Susan Macaulay
- Dementia care advocate and blogger, MyAlzheimersstory.com
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Daneau S, Bourbonnais A, Legault A. Ending the invisible work of nurses: Reflection following a study about nursing support of relatives. aporia 2023. [DOI: 10.18192/aporia.v15i1.6503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023] Open
Abstract
Formerly playing an assistive role motivated by virtue, obedience, and self-denial, nurses are now autonomous professionals with unique expertise, skills, and competencies. However, current recognition of the nursing role is far from optimal and perpetuates the invisibility of nurses’ real work. This article examines one component of the situation: the non-recognition of the nursing role by nurses themselves. Hypotheses explaining this phenomenon, like the history of nursing and the lack of common language, is presented, as well as its impacts, followed by exploration of possible solutions.
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Mailhot T, Maheu-Cadotte MA, Bourbonnais A, Yevchak Sillner A, Charchalis M, Rodriguez D, Lavoie P. Unlicensed assistive personnel's care for persons with or at risk of delirium: a scoping review protocol. JBI Evid Synth 2023:02174543-990000000-00138. [PMID: 36876454 DOI: 10.11124/jbies-22-00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE The objective of this review is to describe the nature and extent of the literature regarding unlicensed assistive personnel's involvement in delivering care to persons with or at risk of delirium. INTRODUCTION Initiatives that promote the involvement of unlicensed assistive personnel in providing additional supervision and care to persons with or at risk of delirium have been developed. Since no standardized approach guides unlicensed assistive personnel's involvement with persons with or at risk of delirium, and since inconsistent training and expectations may pose a threat to the safety and quality of care, it is essential to clarify their role with persons with or at risk of delirium. INCLUSION CRITERIA This review will consider articles published in peer-reviewed journals, dissertations, theses, book chapters, and conference papers in French or English. Quantitative, qualitative, or mixed method studies that report on the development, implementation, or evaluation of the role of unlicensed assistive personnel in contexts of delirium will be included. We will consider editorials and opinion papers only if they report on the development, implementation, or evaluation of the role of unlicensed assistive personnel. METHODS Records will be identified via CINAHL, ProQuest Dissertations & Theses Global, Embase, MEDLINE, APA PsycINFO, and Web of Science. Two independent reviewers will select studies and extract data using a piloted form. Data will be synthesized narratively, using descriptive statistics and a tabular format. A consultation phase will include approximately 24 unlicensed assistive personnel and registered nurses who will be invited to comment on the review findings.
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Affiliation(s)
- Tanya Mailhot
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Montreal Heart Institute, Montreal, QC, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Montreal Heart Institute, Montreal, QC, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Andrea Yevchak Sillner
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | | | | | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Montreal Heart Institute, Montreal, QC, Canada
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Cooke HA, Wu SA, Bourbonnais A, Baumbusch J. Disruptions in Relational Continuity: The Impact of Pandemic Public Health Measures on Families in Long-Term Care. J Fam Nurs 2023; 29:6-17. [PMID: 35674340 PMCID: PMC9850387 DOI: 10.1177/10748407221102462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Although the value of family caregivers' involvement with relatives in long-term care (LTC) is well recognized, tensions remain regarding their role. Such tensions were exacerbated during the COVID-19 pandemic as strict public health measures restricted family access to LTC homes. Using interpretive description, we examined the impact of visitation restrictions on family caregivers' experiences caring for a relative in LTC between March 2020 and June 2021. In-depth interviews were conducted with 14 family caregivers (five spouses and nine adult daughters) and two key themes were identified. The first theme, "seeking to maintain relational continuity," illustrates how caregivers sought to sustain connections with residents prior to and during the pandemic. The second theme, "disrupted relational continuity," highlights the impact of severed relational connections on caregivers' sense of self and ongoing feelings of loss and anger. Findings call for a trauma-informed approach that recognizes the pervasiveness of trauma for family caregivers and the avoidance of re-traumatization.
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Affiliation(s)
| | - Sarah A. Wu
- The University of British Columbia, Vancouver, Canada
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Zarshenas S, Paulino C, Sénéchal I, Décary J, Dufresne A, Bourbonnais A, Aquin C, Bruneau MA, Champoux N, Belchior P, Couture M, Bier N. Application of the Person-Centered Care to Manage Responsive Behaviors in Clients with Major Neurocognitive Disorders: A Qualitative Single Case Study. Clin Gerontol 2023:1-13. [PMID: 36591952 DOI: 10.1080/07317115.2022.2162468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Our study aimed to describe "how" and "why" the person-centered care (PCC) approach was applied within a long-term care (LTC) community to manage responsive behaviors (RBs) in individuals with major neurocognitive disorders. METHODS A descriptive holistic single case study design was employed in the context of an LTC community in Quebec, using semi-structured interviews and non-participatory observations of experienced care providers working with clients with RBs, photographing the physical environment, and accessing documents available on the LTC community's public website. A thematic content analysis was used for data analysis. RESULTS The findings generated insight into the importance of considering multiple components of the LTC community to apply the PCC approach for managing RBs, including a) creating a homelike environment, b) developing a therapeutic relationship with clients, c) engaging clients in meaningful activities, and d) empowering care providers by offering essential resources. CONCLUSIONS Applying and implementing the PCC approach within an LTC community to manage clients' RBs is a long-term multi-dimensional process that requires a solid foundation. CLINICAL IMPLICATIONS These findings highlight the importance of considering multiple factors relevant to persons, environments, and meaningful activities to apply the PCC approach within LTC communities to manage RBs.
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Affiliation(s)
- Sareh Zarshenas
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Canada
| | - Carmela Paulino
- School of rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Isabelle Sénéchal
- School of rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Josianne Décary
- School of rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Audrey Dufresne
- School of rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-sud-de-l'île-de-Montréal, Montréal, Canada
| | - Chloé Aquin
- Institut universitaire de gériatrie de Montréal, CIUSSS Centre-sud-de-l'île-de-Montréal, Montréal, Canada
| | - Marie-Andrée Bruneau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-sud-de-l'île-de-Montréal, Montréal, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Canada
| | - Nathalie Champoux
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-sud-de-l'île-de-Montréal, Montréal, Canada
- Department of Family Medicine, Université de Montréal, Montréal, Canada
| | - Patricia Belchior
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-sud-de-l'île-de-Montréal, Montréal, Canada
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
| | - Melanie Couture
- Centre for Research and Expertise in Social Gerontology, CIUSSS West-Central Montreal, Cote Saint-Luc, Canada
| | - Nathalie Bier
- School of rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-sud-de-l'île-de-Montréal, Montréal, Canada
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8
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Daneau S, Bourbonnais A, Allard É, Asri M, Ummel D, Bolduc E. 'Intensive palliative care': a qualitative study of issues related to nurses' care of people with amyotrophic lateral sclerosis at end-of-life. Palliat Care Soc Pract 2023; 17:26323524231170881. [PMID: 37151782 PMCID: PMC10155001 DOI: 10.1177/26323524231170881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Background Amyotrophic lateral sclerosis (ALS) is currently an incurable and fatal disease, which often comes with a high symptom burden at the end-of-life stage. Little is known about nurses' experiences in this context. Objective To explore the experience of nurses caring for people with ALS at end-of-life. Design A qualitative multiple-case study design. Method Individual semi-structured interviews were conducted between February and August 2022 with nurses from Quebec, Canada, who had provided care to at least one person living with ALS at the end-of-life in the past 12 months. The content analysis method was used for data analysis and within-case and cross-case analyses were conducted, as well as comparative analyses according to the type of position held by the participants that determined the cases: (1) home care, (2) hospital and (3) palliative care home. Results Participating in the study were 24 nurses: 9 were from home care, 8 from hospitals and 7 from palliative care homes. Five main themes were identified: (1) identifying the end-of-life period, (2) communication issues, (3) supporting the need for control, (4) accompanying in the fight culture and (5) the extent of the need for care. A sixth theme was also added in order to report the need expressed by nurses to improve their care of patients living with ALS at end-of-life. Conclusions Although nurses' experiences varied among the different settings, the study identifies the pressing need for better education and, above all, more resources when caring for a person living with ALS at end-of-life. Future research should explore the experiences of other members of the healthcare team and test interventions designed to improve the quality of life and end-of-life of people living with ALS.
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Affiliation(s)
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal,
Montréal, QC, Canada
- Research Chair in Nursing Care for Older People
and their Families, Montréal, QC, Canada
- Canada Research Chair in Care for Older People,
Montréal, QC, Canada
- Research Centre of the Institut universitaire
de gériatrie de Montréal, Montréal, QC, Canada
| | - Émilie Allard
- Faculty of Nursing, Université de Montréal,
Montréal, QC, Canada
- Réseau Québécois de Recherche en Soins
Palliatifs et de Fin de Vie (RQSPAL), Quebec, QC, Canada
- Centre for Research and Intervention on
Suicide, Ethical Issues, and End-of-life Practices (CRISE), Montreal, QC,
Canada
| | - Myriam Asri
- Department of Nursing, Université du Québec à
Trois-Rivières, Trois-Rivières, QC, Canada
| | - Deborah Ummel
- Department of Psychoeducation, Université de
Sherbrooke, Longueuil, QC, Canada
- Réseau Québécois de Recherche en Soins
Palliatifs et de Fin de Vie (RQSPAL), Quebec, QC, Canada
- Centre for Research and Intervention on
Suicide, Ethical Issues, and End-of-life Practices (CRISE), Montreal, QC,
Canada
- Centre de Recherche Charles-Le Moyne (CRCLM),
Longueuil, QC, Canada
| | - Elliot Bolduc
- Department of Psychology, Université du Québec
à Trois-Rivières, Trois-Rivières, QC, Canada
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Fontaine G, Maheu‐Cadotte M, Lavallée A, Mailhot T, Lavoie P, Rouleau G, Vinette B, García MR, Bourbonnais A. Designing, planning, and conducting systematic reviews and other knowledge syntheses: Six key practical recommendations to improve feasibility and efficiency. Worldviews Evid Based Nurs 2022; 19:434-441. [DOI: 10.1111/wvn.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/02/2022] [Accepted: 08/27/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Guillaume Fontaine
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ontario Ottawa Canada
- Faculty of Medicine University of Ottawa Ontario Ottawa Canada
- Centre for Nursing Research Jewish General Hospital Quebec Montreal Canada
| | - Marc‐André Maheu‐Cadotte
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Centre Hospitalier de l'Unibersité de Montréal Quebec Montréal Canada
- Research Centre Montreal Heart Institute Quebec Montréal Canada
| | - Andréane Lavallée
- Nurture Science Program, Department of Pediatrics Columbia University Medical Center New York New York City USA
| | - Tanya Mailhot
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Montreal Heart Institute Quebec Montréal Canada
| | - Patrick Lavoie
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Montreal Heart Institute Quebec Montréal Canada
| | - Geneviève Rouleau
- Institute for Health System Solutions and Virtual Care Women's College Hospital Ontario Toronto Canada
| | - Billy Vinette
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Hôpital Maisonneuve‐Rosemont Québec Montréal Canada
| | - Maria‐Pilar Ramírez García
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Centre Centre Hospitalier de l'Unibersité de Montréal Quebec Montréal Canada
| | - Anne Bourbonnais
- Faculty of Nursing Université de Montréal Quebec Montréal Canada
- Research Center Institut Universitaire de Gériatrie de Montréal Québec Montréal Canada
- Canada Research Chair in Care for Older People Québec Montréal Canada
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Jose A, Sasseville M, Dequanter S, Gorus E, Giguère A, Bourbonnais A, Abbasgholizadeh Rahimi S, Buyl R, Gagnon MP. Existing eHealth Solutions for Older Adults living with Neurocognitive Disorders (Mild and Major) or Dementia and their Informal Caregivers: Protocol for an Environmental Scan (Preprint). JMIR Res Protoc 2022; 11:e41015. [DOI: 10.2196/41015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
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Detthippornpong S, Songwathana P, Bourbonnais A. Holistic Health Practices of Rural Thai Homebound Older Adults: A Focused Ethnographic Study. J Transcult Nurs 2022; 33:521-528. [PMID: 35506516 DOI: 10.1177/10436596221090270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Supporting independent functioning of homebound, chronically ill older adults (HOAs) is a major concern across cultures. In Thailand, actions HOAs take to remain independent and maintain their holistic (mental, physical, and spiritual) health is understudied. Therefore, we explored self-care practices used by rural Thai HOAs to maintain their independence. METHODS We used a focused ethnographic approach, recruiting HOAs, their families, and community members from a rural area in Southern Thailand. Data were analyzed using content analysis. RESULTS Sixteen HOAs and 23 family/community members participated. Three themes emerged: self-care to stay healthy, sharing life with family and society in a positive way, incorporating both folk and modern medicine to maintain health. Factors facilitating holistic health practices were supportive family network, Thai cultural beliefs, community strength and support, and health care services. DISCUSSION/CONCLUSIONS These findings may help health care professionals develop interventions supporting holistic health practices of Thai HOAs to remain independent.
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Dequanter S, Fobelets M, Steenhout I, Gagnon MP, Bourbonnais A, Rahimi S, Buyl R, Gorus E. Determinants of technology adoption and continued use among cognitively impaired older adults: a qualitative study. BMC Geriatr 2022; 22:376. [PMID: 35484488 PMCID: PMC9047390 DOI: 10.1186/s12877-022-03048-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Technology offers opportunities to support older adults with mild cognitive impairments to remain independent and socially connected, but is often not used. Although determinants of technology use among older adults in general are well studied, much less is known about how these factors impact technology use behaviour in cognitively impaired older adults. This study aimed to bridge this gap in research by examining the factors underlying technology use in community-dwelling older adults with mild cognitive impairments. Methods We applied a generic qualitative design and used 16 semi-structured interviews to collect data from Belgian (Flemish) community-dwelling older adults diagnosed with Mild Cognitive Impairment or dementia and informal caregivers. To get data from different perspectives, a focus group with professional caregivers was added. We used thematic analysis with an inductive approach to identify and select themes from the data. Results We identified two themes: introduction of technology and determinants of technology adoption and continued use. Successful technology adoption in cognitively impaired older adults is need-driven and subject to individual, technological and contextual characteristics. Specific for older adults with cognitive impairments are the importance of disease awareness and cognitive ability for adoption and continued use, respectively. Although social support can be a valuable alternative to technology, it is an important facilitator of continued technology use in these older adults. Similarly, integration of technologies in daily routines can buffer discontinuation of technologies. Conclusions Future research is encouraged to validate our findings in a postpandemic era and to further develop a novel theoretical framework for technology acceptance among older adults with cognitive impairments. Moreover, identification of crucial determinants as well as strategies to remove use barriers are also important future research tasks. Clinical practice should focus on improving disease awareness to facilitate technology adoption and policies should invest in training and support of professional caregivers and in reimbursement strategies to facilitate implementation of technology in practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03048-w.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | - Samira Rahimi
- Department of Family Medicine, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,MILA - Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
| | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Department of Gerontology, Faculty of Medicine and Pharmacy, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium. .,Department of Geriatrics, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
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13
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Marulappa N, Anderson NN, Bethell J, Bourbonnais A, Kelly F, McMurray J, Rogers HL, Vedel I, Gagliardi AR. How to implement person-centred care and support for dementia in outpatient and home/community settings: Scoping review. BMC Health Serv Res 2022; 22:541. [PMID: 35459214 PMCID: PMC9034625 DOI: 10.1186/s12913-022-07875-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background Little prior research focused on person-centred care and support (PCCS) for dementia in home, community or outpatient care. We aimed to describe what constitutes PCCS, how to implement it, and considerations for women who comprise the majority of affected persons (with dementia, carers). Methods We conducted a scoping review by searching multiple databases from 2000 inclusive to June 7, 2020. We extracted data on study characteristics and PCCS approaches, evaluation, determinants or the impact of strategies to implement PCCS. We used summary statistics to report data and interpreted findings with an existing person-centred care framework. Results We included 22 studies with qualitative (55%) or quantitative/multiple methods design (45%) involving affected persons (50%), or healthcare workers (50%). Studies varied in how PCCS was conceptualized; 59% cited a PCC definition or framework. Affected persons and healthcare workers largely agreed on what constitutes PCCS (e.g. foster partnership, promote autonomy, support carers). In 4 studies that evaluated care, barriers of PCCS were reported at the affected person (e.g. family conflict), healthcare worker (e.g. lack of knowledge) and organizational (e.g. resource constraints) levels. Studies that evaluated strategies to implement PCCS approaches were largely targeted to healthcare workers, and showed that in-person inter-professional educational meetings yielded both perceived (e.g. improved engagement of affected persons) and observed (e.g. use of PCCS approaches) beneficial outcomes. Few studies reported results by gender or other intersectional factors, and none revealed if or how to tailor PCCS for women. This synthesis confirmed and elaborated the PCC framework, resulting in a Framework of PCCS for Dementia. Conclusion Despite the paucity of research on PCCS for dementia, synthesis of knowledge from diverse studies into a Framework provides interim guidance for those planning or evaluating dementia services in outpatient, home or community settings. Further research is needed to elaborate the Framework, evaluate PCCS for dementia, explore determinants, and develop strategies to implement and scale-up PCCS approaches. Such studies should explore how to tailor PCCS needs and preferences based on input from persons with dementia, and by sex/gender and other intersectional factors such as ethnicity or culture. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07875-w.
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Affiliation(s)
- Nidhi Marulappa
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13EN-228, Toronto, ON, M5G2C4, Canada
| | - Natalie N Anderson
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13EN-228, Toronto, ON, M5G2C4, Canada
| | - Jennifer Bethell
- Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Fiona Kelly
- Division of Nursing, Queen Margaret University, Queen Margaret University Drive, Musselburgh, East Lothian, EH21 6UU, UK
| | - Josephine McMurray
- Lazaridis School of Business and Economics/Health Studies, Wilfrid Laurier University, 73 George Street, Brantford, ON, N3T 3Y3, Canada
| | - Heather L Rogers
- Biocruces Bizkaia Health Research Institute and Ikerbasque Basque Foundation for Science, Bilbao, Spain, Plaza Cruces s/n, E-48903, Barakaldo, Spain
| | - Isabelle Vedel
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13EN-228, Toronto, ON, M5G2C4, Canada.
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14
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Auclair I, Bourbonnais A, Lavoie A, Leclerc-Loiselle J. Inclusion of informal caregivers in the palliative and end-of-life care of older adults: a scoping review protocol. BMJ Open 2022; 12:e053858. [PMID: 35428622 PMCID: PMC9014003 DOI: 10.1136/bmjopen-2021-053858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Palliative and end-of-life (EOL) care will increasingly be required in years to come as a result of an ageing population. An important component of this type of care is the inclusion of informal caregivers, who are family members or friends offering unpaid assistance to older adults with a terminal illness. Although systematic reviews were conducted on topics related to the inclusion of informal caregivers in the palliative and EOL care of older adults, several gaps remain as they were specific to a health condition and/or setting. The purpose of our scoping review is to map the extent of knowledge on this subject. METHODS AND ANALYSIS We will conduct our scoping review following Levac's methodology. We will gather publications of various types through nine databases, manual searches in journals and search engines and reference lists. The selection process will be conducted by two independent reviewers and consist of screening by title and abstract, followed by reading the full text to confirm eligibility. An independent reviewer will then extract data and assess quality from included publications. Data extracted from different publication types will be synthesised together in the Excel software using a content analysis method, with quantitative data transformed into a qualitative description. Results will be presented through descriptive statistics and themes. During different steps of the review, we will also consult informal caregivers and health professionals for feedback as stakeholders. ETHICS AND DISSEMINATION The conduction of this scoping review requires no ethical approval. Results will provide an overview of the state of knowledge on the inclusion of informal caregivers in palliative and EOL of older adults, which could help guide clinical practice, the development of interventions and policy and further research. We will disseminate these results by publishing an article, presenting in conferences, and discussing findings with stakeholders.
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Affiliation(s)
- Isabelle Auclair
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Audrey Lavoie
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
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15
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Mailhot T, Cossette S, Lavoie P, Maheu‐Cadotte M, Fontaine G, Bourbonnais A, Côté J. The development of the MENTOR_D nursing intervention: Supporting family involvement in delirium management. Int J Older People Nurs 2022; 17:e12462. [DOI: 10.1111/opn.12462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 02/15/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Tanya Mailhot
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Sylvie Cossette
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Patrick Lavoie
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
- Centre d’innovation en Formation Infirmière Université de Montréal Montréal QC Canada
| | - Marc‐André Maheu‐Cadotte
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
- Research Centre of the Centre Hospitalier de l’Université de Montréal Montréal QC Canada
| | - Guillaume Fontaine
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut de Cardiologie de Montréal Montréal QC Canada
| | - Anne Bourbonnais
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Institut Universitaire de Gériatrie de Montréal Montréal QC Canada
| | - José Côté
- Faculté des Sciences Infirmières Université de Montréal Montréal QC Canada
- Research Centre of the Centre Hospitalier de l’Université de Montréal Montréal QC Canada
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16
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Daneau S, Bourbonnais A, Legault A. What will happen to my mom? A grounded theory on nurses' support of relatives' end-of-life decision-making process for residents living with dementia in long-term care homes. Dementia (London) 2022; 21:1399-1415. [PMID: 35337201 PMCID: PMC9109588 DOI: 10.1177/14713012221080253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Relatives of an older person living in a long-term care home with
advanced-stage dementia must often make important and difficult decisions,
including ones that impact the resident’s end-of-life. Healthcare
professionals must support them in this decision-making process. The aim of
this study was to propose a theory on nurses’ support of relatives who make
end-of-life decisions for a resident living with dementia in a long-term
care home. Method A constructivist grounded theory approach was used, with a theoretical sample
of nine nurses and 10 relatives whom we met for face-to-face interviews.
Three documents on end-of-life care, which were available in the study
setting, were also included. The analysis was carried out using the method
proposed by Charmaz. Findings The findings highlight the importance of building a strong and trusting
relationship between nurses and relatives. Furthermore, exploring the
refusal of palliative or end-of-life care, supporting relatives’ need to
witness firsthand the condition of the person living with dementia, and
education at a “good” time are useful interventions that nurses can make to
support relatives’ decision-making. Conclusion Better support of relatives in end-of-life decision-making improves the
well-being of relatives and older people living with dementia alike.
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Affiliation(s)
- Stéphanie Daneau
- Department of Nursing, 70351Université du Québec à Trois-Rivières, Drummondville, Québec, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, 63678Université de Montréal, Montréal, Québec, Canada; Chairholder of the Research Chair in Nursing Care for Older People and their Families, Montréal, Québec, Canada; Chairholder of the Canada Research Chair in Care for Older People, Montréal, Québec, Canada; and Researcher, Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - Alain Legault
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
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17
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Dequanter S, Steenhout I, Fobelets M, Gagnon MP, Sasseville M, Bourbonnais A, Giguère A, Ndiaye MA, Lambert A, Gorus E, Buyl R. Technology implementation in care practices for community-dwelling older adults with mild cognitive decline: Perspectives of professional caregivers in Quebec and Brussels. Digit Health 2022; 8:20552076221139693. [PMID: 36420317 PMCID: PMC9677160 DOI: 10.1177/20552076221139693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/01/2022] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVE As worldwide population aging is accelerating, innovative technologies are being developed to support independent living among community-dwelling older adults with mild cognitive decline. However, the successful implementation of these interventions is often challenging. Until now, literature on implementation issues related to the specific context of older adults with mild cognitive decline is lacking and the few studies available do not focus specifically on the perspective of professional caregivers. Yet the perspective of these caregivers is important as they can be considered a key facilitator for technology implementation among this population. Therefore, this study was the first to examine technology implementation among community-dwelling older adults with mild cognitive decline from the broader perspective of professional caregivers. METHODS In this qualitative study, two focus groups consisting of a heterogeneous pool of professional caregivers were conducted: one in Quebec (Canada, n = 6) and one in Brussels (Belgium, n = 8). Braun and Clarke' method for thematic analysis, guided by a qualitative descriptive approach was applied to inductively identify themes from the data. RESULTS We identified factors influencing technology implementation in older adults with mild cognitive decline on three levels: an individual level (e.g., characteristics of older adults with mild cognitive decline and professional caregivers' attitude), an organizational level (e.g., lack of training among professional caregivers) and a level referring to the broader context (e.g., ethical considerations). CONCLUSIONS This study contributes to the research gap in knowledge on the needs of professional caregivers to facilitate technology implementation among the population of older adults with cognitive decline. Future directions for research, practice, and policy are given, more specifically to improve knowledge among caregivers and on the development of decision support to retrieve safe and effective technologies that suit patient-centered care.
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Affiliation(s)
- S Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - I Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Square, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Teacher Education, Vrije Universiteit Brussel, Brussels, Belgium
| | - MP Gagnon
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Quebec, Canada
| | - M Sasseville
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- VITAM Centre de recherche en santé durable, Centre Intégré de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, Canada
| | - A Bourbonnais
- Faculty of Nursing, Université de Montreal, Montreal, Canada
- Research Centre of the Institut Universitaire de gériatrie de Montréal, Canada
| | - A Giguère
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Quebec, Canada
| | - MA Ndiaye
- Arthritis Research Canada, Richmond, Canada
| | - A Lambert
- Department of Nursing Sciences, Université Laval, Quebec, Canada
| | - E Gorus
- Department of Gerontology, Faculty of Medicine and Pharmacy, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, UZ Brussel, Brussels, Belgium
| | - R Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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18
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Dequanter S, Gagnon MP, Ndiaye MA, Gorus E, Fobelets M, Giguère A, Bourbonnais A, Buyl R. The Effectiveness of e-Health Solutions for Aging With Cognitive Impairment: A Systematic Review. Gerontologist 2021; 61:e373-e394. [PMID: 32525977 PMCID: PMC8437510 DOI: 10.1093/geront/gnaa065] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives e-Health solutions are an innovative approach to support aging with cognitive impairment. Because technology is developing at a fast pace, the aim of this review was to present an overview of the research regarding the effectiveness of these solutions. Moreover, the availability of these solutions was examined. Research Design and Methods Systematic searches were conducted in 7 databases. Full texts of potentially relevant references were assessed by 2 reviewers, and discrepancies were solved through discussion. Data on study characteristics, technology type, application domain, availability, outcomes, and effects were extracted. A categorization exercise and narrative synthesis were conducted. Results In total, 72 studies describing 70 e-Health solutions were identified. The majority of solutions comprised cognitive training for older adults, followed by educational and supportive web platforms for caregivers. Outcomes included mainly measures of cognition, psychosocial functioning, caregiving processes, caregiver–care receiver relationship, and activities of daily living. Positive effects of cognitive training technologies were observed on cognitive functioning of older adults, as well as those of supportive web platforms on behavioral and psychological symptoms of dementia and caregiver self-efficacy. The effects of these solutions on depression in both target groups were inconclusive. The methodological quality of the studies was moderate to good. However, some important limitations were observed. Discussion and Implications The review identified cognitive training solutions and supportive web platforms as the most effective on a limited number of outcomes. Although other solutions seem promising, further research has to overcome methodological issues. Furthermore, solutions for leisure and reminiscence and outcomes specifically related to independent living deserve more attention.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
| | - Marie-Pierre Gagnon
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada.,Faculty of Nursing Sciences, Université Laval, Québec, Canada
| | - Mame-Awa Ndiaye
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada
| | - Ellen Gorus
- Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
| | - Anik Giguère
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada.,Faculty of Nursing Sciences, Université Laval, Québec, Canada
| | | | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
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19
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Detthippornpong S, Songwathana P, Bourbonnais A. "Bai Lod" holistic health experienced by homebound older people in the southern Thai community. Int J Older People Nurs 2021; 16:e12364. [PMID: 33471438 DOI: 10.1111/opn.12364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/27/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This qualitative descriptive study aims to explore the meanings of holistic health in the southern Thai culture experienced by homebound older people. BACKGROUND The ageing society necessitates many services to meet the holistic needs of older people. Homebound older people are commonly an understudied population who may view their holistic health and well-being differently from others. Due to geographical differences and local Thai cultural context, exploring the holistic health in the southern Thai culture would help promote a healthy lifestyle and improve their health outcomes. METHODS Based on purposeful sampling, 16 key informants who were homebound older people (ages ≥ 60 years old) living at home in a rural southern Thai community were participated in semi-structured interviews. Informants consisted of six males and ten females who were Buddhist and married. Their ages ranged from 79 to 99, including nine homebound older people who lived in a couple, and seven widows and widowers. Eight had completed the primary school, and others were uneducated. The data were analysed with a content analysis. RESULTS Most of the informants had chronic diseases. In a broad main theme, the informants described the holistic health in local context as 'Bai Lod; which means being alive with positive, active and independent functioning. This theme included three sub-themes: self-supporting or taking care of themselves, having the ability to control their health conditions and being proud as a healthy older adult. The older people described self-supporting as the ability to perform their activities of daily living, take care of their own health and work independently (active living). Having the ability to control their health conditions meant functioning well physically, although being frail, by maintaining their health through self-management, and having a good mental health during such a life-changing situation. Older people valued the ability to live by themselves without being a burden to their family. They felt happy with their life. CONCLUSION Holistic health was described as being positive and active at home, and influenced by beliefs and values related to good physical function, mental health and spiritual activities. These findings could help healthcare professionals better understand older people' health, well-being and cultural care in order to develop alternative strategies to maintain, enhance and support an active life for homebound older people.
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Affiliation(s)
| | | | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.,Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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20
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Bourbonnais A, Auclair I, Lalonde MH. Les comportements des personnes âgées vivant avec un trouble neurocognitif : l’approche centrée sur les relations pour améliorer l’expérience de tous. Rech Soins Infirm 2021:92-105. [PMID: 33485288 DOI: 10.3917/rsi.143.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Older people living with a major neurocognitive disorder often have difficulty communicating. They may exhibit reactive behaviors, such as vocal or aggressive behaviors, which are manifestations of malaise. These behaviors have consequences for these older people, as well as for their relatives and formal caregivers. This article discusses the relationship-centered approach to improving the experience of each of these persons by stimulating a reflection on what unites us. Then, the principles of this relationship-centered approach are outlined, based on the unique needs of each person, the reciprocity of their relationship, and their common aspirations. The application of these principles to older people living with a neurocognitive disorder who exhibit reactive behaviors is reflected through the adoption of consistent language, the identification of the meanings of behaviors and personalized actions, and the establishment of a care partnership. An example of a process integrating this approach is presented, as well as its possible effects. The adoption of this approach may present several challenges in care settings. To meet these challenges, implementation strategies are described promoting the adoption of this approach and contributing to everyone’s well-being.
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21
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Ruest M, Léonard G, Lagueux E, Boissy P, Milot MH, Bourbonnais A, Guay M. Pain assessment of elderly with neurocognitive disorders in long-term care: an occupational lens. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Occupational performance of older adults living in long-term care facilities is influenced by environmental possibilities and service provision. Pain among older adults with neurocognitive disorders might be a factor mitigating functional status. However, pain evaluation during daily routine through advanced stages of the disorder is scarce.
Objective
Identify pain-related behaviors of older adults with neurocognitive disorders during their morning routine in long-term care facilities.
Methods
A multiple-case study based on an embedded concurrent mixed methods design (quan-QUAL) was conducted in Quebec (Canada) in three long-term care units. Older adults with a neurocognitive disorder were observed (from 7:00 to 12:00 AM) and evaluated through the accomplishment of their morning routine. Through inter- and intra-case analyses, pain assessment scales (PACSLAC-II, Algoplus and DS-DAT) and morning routine assessment (occupational therapist's observations of the person, occupations and environment, functional autonomy measure, field notes) were integrated in mixed methods matrixes.
Results
Sixteen (n = 16) participants (average age: 76 years old [59, 93]) with various but advanced functional declines and pain symptoms were included. Participants' significant occupations all related to basic activities of daily living. Hygiene care and getting dressed were occupations for which an alteration of occupational performance was identified.
Conclusions
During their morning routine, older adults with a neurocognitive disorder living in long-term care facilities are facing pain symptoms and occupational deprivation, limiting the fulfilment of their needs and their engagement in occupations. Accordingly, older adults' occupations in relation to their environment should also be considered in future studies investigating pain.
Key messages
Occupational performance of older adults with a neurocognitive disorder living in long term care facilities is limited to basic activities of daily living. Assessment of pain of patients with a neurocognitive disorder in long-term care units should include the identification of environmental and occupational factors contributing to this pain.
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Affiliation(s)
- M Ruest
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
| | - G Léonard
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - E Lagueux
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - P Boissy
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
- Surgery Department, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - M H Milot
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - A Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Canada
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, Canada
| | - M Guay
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
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22
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Buyl R, Beogo I, Fobelets M, Deletroz C, Van Landuyt P, Dequanter S, Gorus E, Bourbonnais A, Giguère A, Lechasseur K, Gagnon MP. e-Health interventions for healthy aging: a systematic review. Syst Rev 2020; 9:128. [PMID: 32493515 PMCID: PMC7271471 DOI: 10.1186/s13643-020-01385-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Healthy aging (HA) is a contemporary challenge for population health worldwide. Electronic health (e-Health) interventions have the potential to support empowerment and education of adults aged 50 and over. OBJECTIVES To summarize evidence on the effectiveness of e-Health interventions on HA and explore how specific e-Health interventions and their characteristics effectively impact HA. METHODS A systematic review was conducted based on the Cochrane Collaboration methods including any experimental study design published in French, Dutch, Spanish, and English from 2000 to 2018. RESULTS Fourteen studies comparing various e-Health interventions to multiple components controls were included. The target population, type of interventions, and outcomes measured were very heterogeneous across studies; thus, a meta-analysis was not possible. However, effect estimates indicate that e-Health interventions could improve physical activity. Positive effects were also found for other healthy behaviors (e.g., healthy eating), psychological outcomes (e.g., memory), and clinical parameters (e.g., blood pressure). Given the low certainty of the evidence related to most outcomes, these results should be interpreted cautiously. CONCLUSIONS This systematic review found limited evidence supporting the effectiveness of e-Health interventions, although the majority of studies show positive effects of these interventions for improving physical activity in older adults. Thus, better quality evidence is needed regarding the effects of e-Health on the physiological, psychological, and social dimensions of HA. SYSTEMATIC REVIEW REGISTRATION The review protocol was registered in PROSPERO (registration number: CRD42016033163).
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Affiliation(s)
- Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Idrissa Beogo
- École des sciences infirmières et des études de la santé/School of Nursing and Health Studies, Université de Saint-Boniface, Winnipeg, Manitoba Canada
| | - Maaike Fobelets
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Carole Deletroz
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, CH-1011 Lausanne, Switzerland
| | - Philip Van Landuyt
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Samantha Dequanter
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ellen Gorus
- Faculty of Medicine and Pharmacy, Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, Quebec Canada
- Research Center of the Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, Quebec Canada
| | - Anik Giguère
- Faculty of Medicine, Université Laval, Quebec, Canada
- Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
- Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), Quebec, Canada
| | - Kathleen Lechasseur
- Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Médecine, Quebec, Canada
| | - Marie-Pierre Gagnon
- Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
- Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), Quebec, Canada
- Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Médecine, Quebec, Canada
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Bourbonnais A, Rousseau J, Lalonde MH, Meunier J, Lapierre N, Gagnon MP. Perceptions and needs regarding technologies in nursing homes: An exploratory study. Health Informatics J 2019; 26:1714-1727. [PMID: 31797712 DOI: 10.1177/1460458219889499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Two of the most salient problems in nursing homes are the responsive behaviours and falls of older people living with Alzheimer's disease and related disorders. Intelligent videomonitoring and mobile applications are potential technologies that may help prevent and manage these problems. However, evidence for the needs for technologies in nursing homes is scarce. This study aimed to explore the perceptions and needs of care managers, and of formal and family caregivers in nursing homes regarding these potential technologies. With an exploratory qualitative design based on Rogers' diffusion of innovation theory, individual interviews and a content analysis were conducted. Results show that the potential users of these technologies consider them relevant in nursing homes. The characteristics that would make these technologies useful in nursing homes are described. These results could be used to develop useful technologies to improve the quality of clinical practice in nursing homes.
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Affiliation(s)
| | - Jacqueline Rousseau
- Université de Montréal, Canada; Research Centre of the Institut universitaire de gériatrie de Montréal, Canada
| | | | | | - Nolwenn Lapierre
- Research Centre of the Institut universitaire de gériatrie de Montréal, Canada
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Daneau S, Bourbonnais A, Legault A. Surrogates' end-of-life decision-making process in nursing homes for residents with a neurocognitive disorder: An integrative review. Int J Older People Nurs 2019; 15:e12274. [PMID: 31612638 DOI: 10.1111/opn.12274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 08/16/2019] [Accepted: 08/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The goal of this review is to analyse articles on the experience of surrogates who find themselves making end-of-life decisions for a relative with a major neurocognitive disorder in a nursing home. DESIGN An integrative review of the literature based on Whittemore and Knafl's method. DATA SOURCES This review used the CINAHL, PubMed, PsycInfo, Embase and Web of Science databases. A complementary search was also conducted via citation pearl searching, and the reference lists from the selected articles were manually verified. REVIEW METHOD The quality of the selected articles was assessed using the Crow Critical Appraisal Tool, and the data were extracted systematically and were then organised according to Mishel's uncertainty in illness theory. The data that did not correspond to any concept of the theory were excluded at this stage. Analysis was conducted using the method put forward by Miles, Huberman and Saldaña. RESULTS A total of 18 articles were selected: 11 qualitative, 5 quantitative and 1 using a mixed method, as well as 1 ethical argument. The subjects arising from the analysis of the articles were the types of decisions made, the support available for the surrogates, the role and involvement of the surrogates in the process and the factors that influence the decisions. CONCLUSION The results of this integrative review stimulate reflection on the needs of family members involved in making decisions, as well as on the nursing practice and research. Published literature is mainly from North America, and thus, more research is needed to better understand the impact of cultural and ethnic differences in the process, which was poorly covered by the existing literature. Also, exploring nurses' involvement in supporting surrogates may eventually better equip nurses for their interventions with surrogates. IMPLICATIONS FOR PRACTICE Describing the illness progression and the signification of palliative care to the resident with a NCD and their surrogate decision makers, as well as discussing end-of-life care preferences as early as possible are all nursing interventions that could potentially enhance surrogates' end-of-life decision-making process.
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Affiliation(s)
- Stéphanie Daneau
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Chair in Nursing Care for Older People and their Families, Montréal, QC, Canada.,Department of Nursing, Université du Québec à Trois-Rivières, Drummondville, QC, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Chair in Nursing Care for Older People and their Families, Montréal, QC, Canada.,Research Center of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Alain Legault
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
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Fontaine G, Maheu-Cadotte MA, Lavallée A, Mailhot T, Rouleau G, Bouix-Picasso J, Bourbonnais A. Communicating Science in the Digital and Social Media Ecosystem: Scoping Review and Typology of Strategies Used by Health Scientists. JMIR Public Health Surveill 2019; 5:e14447. [PMID: 31482854 PMCID: PMC6751098 DOI: 10.2196/14447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/06/2019] [Accepted: 07/29/2019] [Indexed: 01/23/2023] Open
Abstract
Background The public’s understanding of science can be influential in a wide range of areas related to public health, including policy making and self-care. Through the digital and social media ecosystem, health scientists play a growing role in public science communication (SC). Objective This review aimed to (1) synthesize the literature on SC initiated by health scientists targeting the public in the digital and social media ecosystem and (2) describe the SC strategies and communication channels used. Methods This scoping review was based on the Joanna Briggs Institute Methodological Framework. A systematic search was performed in 6 databases (January 2000 to April 2018). Title and abstract screening, full-text review, data charting, and critical appraisal were performed independently by two review authors. Data regarding included studies and communication channels were synthesized descriptively. A typology of SC strategies was developed using a qualitative and inductive method of data synthesis. Results Among 960 unique publications identified, 18 met inclusion criteria. A third of publications scored good quality (6/18, 33%), half scored moderate quality (9/18, 50%), and less than a fifth scored low quality (3/18, 16%). Overall, 75 SC strategies used by health scientists were identified. These were grouped into 9 types: content, credibility, engagement, intention, linguistics, planification, presentation, social exchange, and statistics. A total of 5 types of communication channels were identified: social networking platforms (eg, Twitter), content-sharing platforms (eg, YouTube), digital research communities (eg, ResearchGate), personal blogs and websites (eg, WordPress), and social news aggregation and discussion platforms (eg, Reddit). Conclusions Evidence suggests that multiple types of SC strategies and communication channels are used by health scientists concurrently. Few empirical studies have been conducted on SC by health scientists in the digital and social media ecosystem. Future studies should examine the appropriateness and effectiveness of SC strategies for improving public health–related outcomes and identify the barriers, facilitators, and ethical considerations inherent to the involvement of health scientists in the digital and social media ecosystem.
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Montreal Heart Institute, Montréal, QC, Canada.,Research Center, Université de Montréal Hospital Center, Montréal, QC, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, CHU Sainte-Justine, Montréal, QC, Canada
| | - Tanya Mailhot
- Department of Pharmacy and Health Systems Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Geneviève Rouleau
- Research Center, Université de Montréal Hospital Center, Montréal, QC, Canada.,Faculty of Nursing, Université Laval, Québec City, QC, Canada
| | - Julien Bouix-Picasso
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Health Education and Practice Laboratory, The Faculty of Health, Medicine and Human Biology, Université Paris 13 Nord, Paris, France.,French Military Health Service Academy, Department for Non-Medical Personnel Education, École du Val-de-Grâce, Paris, France
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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Bourbonnais A, Rousseau J, Lalonde MH, Meunier J, Lapierre N, Gagnon MP. Conditions and ethical challenges that could influence the implementation of technologies in nursing homes: A qualitative study. Int J Older People Nurs 2019; 14:e12266. [PMID: 31475466 DOI: 10.1111/opn.12266] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/26/2019] [Accepted: 07/18/2019] [Indexed: 11/28/2022]
Abstract
AIM To explore the conditions that may influence the implementation of an interactive mobile application (app) and an intelligent videomonitoring system (IVS) in nursing homes (NHs) and the ethical challenges of their use. BACKGROUND There is a lack of knowledge about implementing technologies in NHs and the ethical challenges that might arise. In past studies, nursing care teams expressed the need for technologies offering clinical support. Technologies like an IVS and an app could prove useful in NHs to prevent and manage falls and responsive behaviours. DESIGN An exploratory qualitative study was conducted with care managers, family caregivers and formal caregivers in five NHs. METHODS Each participant was shown a presentation of a potential app and a short video on an IVS. It was followed by an individual semi-structured interview. A conventional content analysis was performed. FINDINGS Potential users found it would be possible to implement these technologies in NHs even if resistance could be expected. To facilitate adoption and achieve clinical benefits, the implementation of technologies should be pilot-tested, and coaching activities should be planned. Ethical risks were considered already present in NHs even without technologies, for example, risks to privacy. Strategies were proposed, for instance, to adapt the code of ethics and procedures. Some potential prejudices about the interest and abilities of older staff, nurses' aides, and family caregivers to use technology were identified. CONCLUSIONS Through rigorous and ethical implementation, technologies supporting clinical care processes could benefit older people living in NHs, as well as their relatives and the staff. IMPLICATIONS FOR PRACTICE Various strategies are proposed to successfully implement technologies. Effort should be made to avoid prejudices during implementation, and procedures should be adapted to mitigate possible ethical challenges.
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Affiliation(s)
- Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jacqueline Rousseau
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | - Marie-Hélène Lalonde
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jean Meunier
- Department of Computer Science and Operations Research, Université de Montréal, Montréal, QC, Canada
| | - Nolwenn Lapierre
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Gagnon
- Faculty of Nursing, Université Laval, Québec City, QC, Canada.,Research Centre of the Centre hospitalier universitaire de Québec, Québec City, QC, Canada
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Charette M, Goudreau J, Bourbonnais A. How do new graduated nurses from a competency-based program demonstrate their competencies? A focused ethnography of acute care settings. Nurse Educ Today 2019; 79:161-167. [PMID: 31132728 DOI: 10.1016/j.nedt.2019.05.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/21/2019] [Accepted: 05/19/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Following major organizations' recommendations, healthcare professionals' education has been reformed in the last decade into competency-based education (CBE) to better prepare them with core competencies. This change was intended to prepare new graduates for the reality of health systems and future challenges. Few studies have focused on how new graduate nurses (NGNs) from these reformed programs use the competencies they have developed. OBJECTIVE To describe the competencies of NGNs from a Canadian competency-based baccalaureate program, as perceived by various actors in acute-care settings. METHODS A focused ethnography was conducted on three acute-care wards of an academic hospital. Participants (n = 19) from four subgroups (NGNs, preceptors, clinical nurse specialists, and nurse managers) participated in individual semi-structured interviews or focus groups. Data were also collected through observation and fieldnotes; an ethnographic analysis framework was used. RESULTS Three themes were identified to describe the deployment of NGNs' competencies: NGNs' appropriation of their new role, fragmentation of practice into tasks, and development of practice; NGNs' collaboration within the interprofessional team, management of the dyad with licensed practical nurses, and ability to integrate patients and families into the team; and NGNs' scientific practice, increased scientific curiosity, and use of credible sources. Analysis of these themes' elements in light of the competency framework of the program showed that NGNs deploy seven of the eight competencies developed during their training. CONCLUSION This study's results can be applied by nursing educators and hospital decision makers to ensure NGNs are able to use their competencies and to smoothen the transition period between the academic and clinical settings.
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Affiliation(s)
- Martin Charette
- Faculty of Nursing, Université de Montréal, Montréal, Canada; Centre for Innovation in Nursing Education, Montréal, Canada.
| | - Johanne Goudreau
- Faculty of Nursing, Université de Montréal, Montréal, Canada; Centre for Innovation in Nursing Education, Montréal, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Canada; Research Centre of the Institut Universitaire de Gériatrie de Montréal, Canada
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Bourbonnais A, Goulet MH, Landreville P, Ellefsen E, Larue C, Lalonde MH, Gendreau PL. Physically aggressive behaviors in older people living with cognitive disorders: a systematic scoping review protocol. Syst Rev 2019; 8:164. [PMID: 31296261 PMCID: PMC6621942 DOI: 10.1186/s13643-019-1091-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 07/02/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Physically aggressive behaviors are very common among older people living with cognitive impairment. These behaviors may have significant consequences for family and formal caregivers, as well as for the other people in the older people's environment, and are also a frequent cause of institutionalization. Two relevant systematic reviews have been published on the subject but do not specifically target physically aggressive behaviors or only focus on care in nursing homes. Moreover, they do not address the causes, associated factors, and consequences of these behaviors, even though these should indeed be considered when developing interventions. Thus, the purpose of this scoping review is to map the state of knowledge on these physically aggressive behaviors with a view to developing personalized interventions. Offering a humanist and relational perspective by which these behaviors may be examined, the Senses Framework will guide this review. METHODS The scoping review method of Levac, Colquhoun, and O'Brien will be used. Several databases (e.g., CINAHL, PubMed, PsycINFO, SCOPUS, Grey Literature Report, clinical trials registries) will be searched for literature published in the past 15 years, using a combination of keywords and descriptors. Other data sources will be used to identify non-indexed literature or unpublished results (e.g., articles references, journal tables of content, contact with key authors). The literature will be selected regardless of setting, if it concerns older people, aged 65, or older with cognitive impairment who present physically aggressive behaviors. Data will be extracted systematically by the research team. A quality assessment of the literature will be done to consider this aspect in the data synthesis. A content analysis will be used to synthesize the results. DISCUSSION No scoping review has been found on the physically aggressive behaviors of older people living with cognitive impairment in various settings. The results of this review will identify needs for further research and for clinical and training development on this problem from a humanist standpoint. SYSTEMATIC REVIEW REGISTRATION Currently, it is not possible to register a systematic scoping review protocol (e.g., PROSPERO).
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Affiliation(s)
- Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Research Chair in Nursing Care for Older People and their Families, Research Centre of the Institut universitaire de gériatrie de Montréal, PO Box 6128, Station Centre-Ville, Montréal, Quebec H3C 3J7 Canada
| | - Marie-Hélène Goulet
- Faculty of Nursing, Université de Montréal, PO Box 6128, Station Centre-Ville, Montréal, Quebec H3C 3J7 Canada
| | - Philippe Landreville
- School of Psychology, Université Laval, 2325 Allée des Bibliothèques, Québec City, Quebec G1V 0A6 Canada
| | - Edith Ellefsen
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Quebec J4K 0A8 Canada
| | - Caroline Larue
- Faculty of Nursing, Université de Montréal, PO Box 6128, Station Centre-Ville, Montréal, Quebec H3C 3 J7 Canada
| | - Marie-Hélène Lalonde
- Research Centre of the Institut universitaire de gériatrie de Montréal, 4565 Queen Mary, Montréal, Quebec H3W 1W5 Canada
| | - Paul L. Gendreau
- Department of Psychoeducation, Université de Montréal, PO Box 6128, Station Centre-Ville, Montréal, Quebec H3C 3J7 Canada
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Charette M, Goudreau J, Bourbonnais A. Factors influencing the practice of new graduate nurses: A focused ethnography of acute care settings. J Clin Nurs 2019; 28:3618-3631. [PMID: 31190368 DOI: 10.1111/jocn.14959] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/16/2019] [Accepted: 05/26/2019] [Indexed: 11/28/2022]
Abstract
AIM To explore the influence of an acute care setting on competency deployment of new graduate nurses (NGNs) from a competency-based undergraduate programme. BACKGROUND In the last 15 years, nursing education has shifted to competency-based education (CBE). Few studies have focused on how NGNs from these reformed programmes use the competencies they have developed. To be paradigmatically coherent with the nature of a competence, studies should also examine how context influences nursing practice and competency deployment. DESIGN A focused ethnography of three acute care units from one academic hospital in Canada. METHODS Purposive and snowball sampling strategies were used to recruit 19 participants: NGNs (n = 4), nurse preceptors (n = 2), clinical nurse specialists (n = 9) and nurse managers (n = 4). Data were collected through individual interviews, focus groups, observation and documentation. Data were analysed according to Roper and Shapira (Ethnography in nursing research. Thousand Oaks, CA: Sage Publications, 2000) ethnographic nursing analysis framework. RESULTS Organisational and individual factors were identified as influencing NGNs' competency deployment. Organisational factors are orientation, stability, workload and the scientific culture of the unit. Personal factors have been linked to groups of professionals: for NGNs, personality and clinical placements during their initial education; for nurses working with NGNs, to be role models, to promote integration and to denounce bullying; and for other health professionals, to recognise nursing expertise. CONCLUSION One way to smooth the transition from academic to clinical settings for NGNs is by offering transition or orientation programmes that will provide them with stability and a reduced workload, allowing them to progressively deploy their competencies. RELEVANCE TO CLINICAL PRACTICE Organisational and individual factors influence how new graduate nurses deploy their competencies. Clinical educators and nurse managers can help new nurses by acting on these factors. This study conforms to the COREQ Research Reporting Guidelines for qualitative studies.
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Affiliation(s)
- Martin Charette
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Centre for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Johanne Goudreau
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Centre for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Centre for Innovation in Nursing Education, Faculty of Nursing, Université de Montréal, Montréal, Canada.,Research Centre of the Institut Universitaire de gériatrie de Montréal, Montréal, Canada
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Kayser JW, Cossette S, Côté J, Tanguay JF, Tremblay JF, Diodati JG, Bourbonnais A, Purden M, Juneau M, Terrier J, Dupuis J, Maheu-Cadotte MA, Fontaine G, Cournoyer D. A web-based tailored nursing intervention (TAVIE en m@rche) aimed at increasing walking after an acute coronary syndrome: Multicentre randomized trial. J Adv Nurs 2019; 75:2727-2741. [PMID: 31225667 DOI: 10.1111/jan.14119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 04/13/2019] [Accepted: 04/17/2019] [Indexed: 11/26/2022]
Abstract
AIM Evaluate a web-based tailored nursing intervention, TAVIE en m@rche, on increasing daily steps after an acute coronary syndrome. DESIGN Parallel two-group multicentre randomized trial. METHODS An experimental group receiving TAVIE en m@rche, was compared to a control group receiving hyperlinks to public websites. Acute coronary syndrome patients who were insufficiently active were recruited from three coronary care units. Daily steps at 12 weeks were the primary outcome. Secondary outcomes included self-reported walking and moderate to vigorous physical activity (MVPA). Exploratory outcomes were angina frequency, emergency department visits, hospitalizations and secondary prevention programme attendance. RESULTS Primary data were analysed for 39 participants. No significant effects were found. At 12 weeks 275.9 more daily steps and 1,464.3 more energy expenditure in MVPA were found in the experimental group relative to the control. No effects were found for angina frequency, emergency department visits, hospitalizations and secondary prevention programme attendance. CONCLUSION The lack of effect on our primary result may be explained by the intervention goal that was mismatched to the needs of our mostly sufficiently active sample at randomization, resulting in no meaningful change in daily steps. Although the non-significantly greater increase in self-reported MVPA may represent gains in health among the participants that accessed TAVIE en m@rche, this result should be interpreted with caution. IMPACT From 40%-60% of acute coronary syndrome patients self-report insufficient levels of physical activity. No effect was found on the primary outcome of daily steps. Although not significant, a greater increase in MVPA was found at 12 weeks. The primary outcome can be explained by most of the sample having attained the physical activity recommendation at randomization. Caution in interpreting the non-significant increase in MVPA is warranted due to attrition bias and statistical uncertainty. Future directions may consider the timing of randomization in relation to meeting the needs of insufficiently active acute coronary syndrome patients.
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Affiliation(s)
- John William Kayser
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Jean-Francois Tanguay
- Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Jean-Francois Tremblay
- Integrated Health and Social Services Centres, l'Est de l'Île de Montréal, Montréal, Quebec, Canada
| | | | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Research Center of the Institut universitaire de gériatrie de Montréal, Montréal, Quebec, Canada
| | - Margaret Purden
- Ingram School of Nursing, McGill University, Montréal, Quebec, Canada.,Jewish General Hospital Centre for Nursing Research, Montréal, Quebec, Canada
| | - Martin Juneau
- Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Julien Terrier
- Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montréal, Quebec, Canada.,Montreal Heart Institute Research Center, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Daniel Cournoyer
- Montreal Health Innovations Coordinating Center, Montréal, Quebec, Canada
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Bourbonnais A, Michaud C. Once upon a time: Storytelling as a knowledge translation strategy for qualitative researchers. Nurs Inq 2018; 25:e12249. [DOI: 10.1111/nin.12249] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 05/03/2018] [Accepted: 05/13/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Anne Bourbonnais
- Faculty of Nursing; Université de Montréal; Montréal Québec Canada
- Research Chair in Nursing Care for Older People and Their Families; Research Centre of the Institut universitaire de gériatrie de Montréal; Montréal Québec Canada
| | - Cécile Michaud
- School of Nursing; Université de Sherbrooke; Longueuil Québec Canada
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Bourbonnais A, Ducharme F, Landreville P, Michaud C, Gauthier MA, Lavallée MH. An Action Research to Optimize the Well-Being of Older People in Nursing Homes: Challenges and Strategies for Implementing a Complex Intervention. J Appl Gerontol 2018; 39:119-128. [DOI: 10.1177/0733464818762068] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Few studies have been conducted on strategies to promote the implementation of complex interventions in nursing homes (NHs). This article presents a pilot study intended to assess the strategies that would enable the optimal implementation of a complex intervention approach in NHs based on the meanings of screams of older people living with Alzheimer’s disease. An action research approach was used with 19 formal and family caregivers from five NHs. Focus groups and individual interviews were held to assess different implementation strategies. A number of challenges were identified, as were strategies to overcome them. These latter included interactive training, intervention design, and external support. This study shows the feasibility of implementing a complex intervention to optimize older people’s well-being. The article shares strategies that may promote the implementation of these types of interventions in NHs.
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Affiliation(s)
- Anne Bourbonnais
- Université de Montréal, Québec, Canada
- Institut universitaire de gériatrie de Montréal, Québec, Canada
| | - Francine Ducharme
- Université de Montréal, Québec, Canada
- Institut universitaire de gériatrie de Montréal, Québec, Canada
| | | | | | - Marie-Andrée Gauthier
- Centre intégré de santé et de services sociaux de la Montérégie-Ouest, Châteauguay, Québec, Canada
| | - Marie-Hélène Lavallée
- Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Québec, Canada
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Fontaine G, Lavallée A, Maheu-Cadotte MA, Bouix-Picasso J, Bourbonnais A. Health science communication strategies used by researchers with the public in the digital and social media ecosystem: a systematic scoping review protocol. BMJ Open 2018; 8:e019833. [PMID: 29382682 PMCID: PMC5829594 DOI: 10.1136/bmjopen-2017-019833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The optimisation of health science communication (HSC) between researchers and the public is crucial. In the last decade, the rise of the digital and social media ecosystem allowed for the disintermediation of HSC. Disintermediation refers to the public's direct access to information from researchers about health science-related topics through the digital and social media ecosystem, a process that would otherwise require a human mediator, such as a journalist. Therefore, the primary aim of this scoping review is to describe the nature and the extent of the literature regarding HSC strategies involving disintermediation used by researchers with the public in the digital and social media ecosystem. The secondary aim is to describe the HSC strategies used by researchers, and the communication channels associated with these strategies. METHODS AND ANALYSIS We will conduct a scoping review based on the Joanna Briggs Institute's methodology and perform a systematic search of six bibliographical databases (CINAHL, EMBASE, IBSS, PubMed, Sociological Abstracts and Web of Science), four trial registries and relevant sources of grey literature. Relevant journals and reference lists of included records will be hand-searched. Data will be managed using the EndNote software and the Rayyan web application. Two review team members will perform independently the screening process as well as the full-text assessment of included records. Descriptive data will be synthesised in a tabular format. Data regarding the nature and the extent of the literature, the HSC strategies and the associated communication channels will be presented narratively. ETHICS AND DISSEMINATION This review does not require institutional review board approval as we will use only collected and published data. Results will allow the mapping of the literature about HSC between researchers and the public in the digital and social media ecosystem, and will be published in a peer-reviewed journal.
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Affiliation(s)
- Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
- Research Center, Montreal Heart Institute, Montréal, Quebec, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
- Research Center, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Marc-André Maheu-Cadotte
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
- Research Center, Montreal Heart Institute, Montréal, Quebec, Canada
- Research Center, Centre hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - Julien Bouix-Picasso
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
- Laboratoire Educations et Pratiques en Santé (EA 3412), Service santé des armées, Université Paris 13 Ecole du Val-de-Grâce, Paris, Île-de-France, France
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, Québec, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Québec, Canada
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Bourbonnais A, Ducharme F, Landreville P, Michaud C, Gauthier MA, Lavallée MH. [Not Available]. Perspect Infirm 2018; 15:27-32. [PMID: 29342333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Anne Bourbonnais
- Faculté des sciences infimières de l'Universitré de Montréal, Québec, Canada
| | - Francine Ducharme
- Faculté des sciences infimières de l'Universitré de Montréal, Québec, Canada
| | | | - Cécile Michaud
- École des sciences infimières de l'Universitré de Sherbrooke, Québec, Canada
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Bruneau M, Bier N, Bourbonnais A, Ménard C, Dubé C. [P2–481]: BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA: A TELECONSULTATION AND MENTORING PROJECT. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Nathalie Bier
- Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal (CRIUGM)MontrealQCCanada
| | - Anne Bourbonnais
- Centre de Recherche de l'Institut Universitaire de Gériatrie de MontréalMontréalQCCanada
| | - Caroline Ménard
- Institut Universitaire de Gériatrie de MontréalMontréalQCCanada
| | - Catherine Dubé
- Centre de Recherche de l'Institut Universitaire de Gériatrie de MontréalMontréalQCCanada
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Bourbonnais A, Rousseau J, Meunier J, Gagnon M, Lalonde M, Lapierre N, Trudeau D. BEHAVIORAL SYMPTOMS AND FALLS IN LONG-TERM CARE FACILITIES: PERCEPTIONS OF GERONTECHNOLOGY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A. Bourbonnais
- Université de Montréal, Montreal, Quebec, Canada,
- Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
| | - J. Rousseau
- Université de Montréal, Montreal, Quebec, Canada,
- Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
| | - J. Meunier
- Université de Montréal, Montreal, Quebec, Canada,
| | - M. Gagnon
- Université Laval, Quebec, Quebec, Canada,
| | - M. Lalonde
- Université de Montréal, Montreal, Quebec, Canada,
- Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
| | - N. Lapierre
- Université de Montréal, Montreal, Quebec, Canada,
- Research Centre of the Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada,
| | - D. Trudeau
- Centre Intégré des Services de Santé et Services Sociaux du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
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Kayser JW, Cossette S, Côté J, Bourbonnais A, Purden M, Juneau M, Tanguay JF, Simard MJ, Dupuis J, Diodati JG, Tremblay JF, Maheu-Cadotte MA, Cournoyer D. Evaluation of a Web-Based Tailored Nursing Intervention (TAVIE en m@rche) Aimed at Increasing Walking After an Acute Coronary Syndrome: A Multicenter Randomized Controlled Trial Protocol. JMIR Res Protoc 2017; 6:e64. [PMID: 28450272 PMCID: PMC5427251 DOI: 10.2196/resprot.6430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 02/01/2017] [Accepted: 02/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the health benefits of increasing physical activity in the secondary prevention of acute coronary syndrome (ACS), up to 60% of ACS patients are insufficiently active. Evidence supporting the effect of Web-based interventions on increasing physical activity outcomes in ACS patients is growing. However, randomized controlled trials (RCTs) using Web-based technologies that measured objective physical activity outcomes are sparse. OBJECTIVE Our aim is to evaluate in insufficiently active ACS patients, the effect of a fully automated, Web-based tailored nursing intervention (TAVIE en m@rche) on increasing steps per day. METHODS A parallel two-group multicenter RCT (target N=148) is being conducted in four major teaching hospitals in Montréal, Canada. An experimental group receiving the 4-week TAVIE en m@rche intervention plus a brief "booster" at 8 weeks, is compared with the control group receiving hyperlinks to publicly available websites. TAVIE en m@rche is based on the Strengths-Based Nursing Care orientation to nursing practice and the Self-Determination Theory of human motivation. The intervention is centered on videos of a nurse who delivers the content tailored to baseline levels of self-reported autonomous motivation, perceived competence, and walking behavior. Participants are recruited in hospital and are eligible if they report access to a computer and report less than recommended physical activity levels 6 months before hospitalization. Most outcome data are collected online at baseline, and 5 and 12 weeks postrandomization. The primary outcome is change in accelerometer-measured steps per day between randomization and 12 weeks. The secondary outcomes include change in steps per day between randomization and 5 weeks, and change in self-reported energy expenditure for walking and moderate to vigorous physical activity between randomization, and 5 and 12 weeks. Theoretical outcomes are the mediating role of self-reported perceived autonomy support, autonomous and controlled motivations, perceived competence, and barrier self-efficacy on steps per day. Clinical outcomes are quality of life, smoking, medication adherence, secondary prevention program attendance, health care utilization, and angina frequency. The potential moderating role of sex will also be explored. Analysis of covariance models will be used with covariates such as sex, age, fatigue, and depression symptoms. Allocation sequence is concealed, and blinding will be implemented during data analysis. RESULTS Recruitment started March 30, 2016. Data analysis is planned for November 2017. CONCLUSIONS Finding alternative interventions aimed at increasing the adoption of health behavior changes such as physical activity in the secondary prevention of ACS is clearly needed. Our RCT is expected to help support the potential efficacy of a fully automated, Web-based tailored nursing intervention on the objective outcome of steps per day in an ACS population. If this RCT is successful, and after its implementation as part of usual care, TAVIE en m@rche could help improve the health of ACS patients at large. TRIAL REGISTRATION ClinicalTrials.gov NCT02617641; https://clinicaltrials.gov/ct2/show/NCT02617641 (Archived by WebCite at http://www.webcitation.org/6pNNGndRa).
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Affiliation(s)
- John William Kayser
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Sylvie Cossette
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - José Côté
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Anne Bourbonnais
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Research Center of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Margaret Purden
- McGill University, Ingram School of Nursing, Montréal, QC, Canada.,Jewish General Hospital Centre for Nursing Research, Montréal, QC, Canada
| | - Martin Juneau
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Jean-Francois Tanguay
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Marie-Josée Simard
- Integrated Health and Social Services Centres, l'Est de l'Île de Montréal, Montréal, QC, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | | | | | - Marc-André Maheu-Cadotte
- Université de Montréal, Faculty of Nursing, Montréal, QC, Canada.,Montreal Heart Institute Research Center and Université de Montréal, Montréal, QC, Canada
| | - Daniel Cournoyer
- Montreal Health Innovations Coordinating Center, Montréal, QC, Canada
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Mailhot T, Cossette S, Côté J, Bourbonnais A, Côté MC, Lamarche Y, Denault A. A post cardiac surgery intervention to manage delirium involving families: a randomized pilot study. Nurs Crit Care 2017; 22:221-228. [PMID: 28371230 DOI: 10.1111/nicc.12288] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/28/2016] [Accepted: 01/23/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND As many delirium manifestations (e.g., hallucinations or fears) are linked to patients' experiences and personality traits, it is suggested that interventions should be tailored to optimize its management. The inclusion of family members, as part of an intervention, has recently emerged as a solution to developing individualised patient care, but has never been assessed in post-cardiac surgery intensive care unit where almost half of patients will present with delirium. AIMS To assess the feasibility, acceptability and preliminary efficacy of an nursing intervention involving family caregivers (FC) in delirium management following cardiac surgery. DESIGN A randomized pilot study. METHODS A total of 30 patient/FC dyads were recruited and randomized to usual care (n = 14) or intervention (n = 16). The intervention was based on the Human Caring Theory, a mentoring model, and sources informing self-efficacy. It comprised seven planned encounters spread over 3 days between an intervention nurse and the FC, each including a 30-min visit at the patient's bedside. During this bedside visit, the FC used delirium management strategies, e.g. reorient the person with delirium. The primary indicator of acceptability was to obtain consent from 75% of approached FCs. The preliminary effect of the intervention on patient outcomes was assessed on (1) delirium severity using the Delirium Index, (2) occurrence of complications, such as falls, (3) length of postoperative hospital stay and (4) psycho-functional recovery using the Sickness Impact Profile. The preliminary effect on FC outcomes was assessed on FC anxiety and self-efficacy. Data were analysed using descriptive statistics, ANCOVAs and logistic regressions. RESULTS The primary indicator of obtaining consent from FC was achieved (77%). Of the 14 dyads, thirteen (93%) dyads received all seven encounters planned in the experimental intervention. Intervention group patients presented better psycho-functional recovery scores when compared with control group patients (p = 0·01). Mean delirium severity scores showed similar trajectories on days 1, 2 and 3 in both groups. CONCLUSION The mentoring intervention was acceptable and feasible and shows promising results in improving patients and FC outcomes. RELEVANCE TO CLINICAL PRACTICE Nurses should involve, if willing, FC to participate in activities that optimise patient well-being FC to use recognized delirium management strategies like reorientation and reassurance.
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Affiliation(s)
- Tanya Mailhot
- Montreal Heart Institute Research Center S-2490, University of Montreal, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
| | - Sylvie Cossette
- University of Montreal, Montreal Heart Institute Research Center S-2510, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
| | - José Côté
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, University of Montreal, PO Box 6128, Downtown Branch, Montréal (Québec) H3C 3J7, Canada
| | - Anne Bourbonnais
- University of Montreal, Chair of the Desjardins Research, Chair in Nursing Care for Older People and their Families, Centre de recherche de l'Institut universitaire de gériatrie de Montréal, PO Box 6128, Downtown Branch, Montréal (Québec) H3C 3J7, Canada
| | - Marie-Claude Côté
- Department of Psychosomatics, Montreal Heart Institute, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
| | - Yoan Lamarche
- Department of Cardiac Surgery, Montreal Heart Institute, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
| | - André Denault
- Department of Anesthesiology, Montreal Heart Institute, 5000 Belanger Street, Montreal (Quebec) H1T 1C8, Canada
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Lavallée A, Aita M, Bourbonnais A, De Clifford-Faugère G. Effectiveness of early interventions for parental sensitivity following preterm birth: a systematic review protocol. Syst Rev 2017; 6:62. [PMID: 28335806 PMCID: PMC5364600 DOI: 10.1186/s13643-017-0459-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/15/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Parental sensitivity is the interaction process by which parents (a) recognize cues from their infant, (b) interpret these cues adequately, (c) identify an appropriate response and (d) apply this response in an appropriate time frame. In the neonatal intensive care unit, parents of preterm infants often encounter factors hampering the establishment of their parental sensitivity. Parents report the need to be in proximity to and to participate in their preterm infant's care in order to develop their sensitivity to their newborn infant. To do so, the effectiveness of interventions promoting their parental sensitivity has been evaluated with randomized controlled trials. The purpose of this systematic review is to evaluate the effectiveness of early interventions promoting parental sensitivity of preterm infants' parents. METHODS/DESIGN A search will be done in the following databases: CINAHL, PubMed in addition to Medline, Embase, PsycInfo, Web of Science, Scopus and ProQuest. No restriction for the years of publication will be considered. Two experts will be conducting independently each step of the review. All studies of randomized controlled trials of early interventions, for parents of preterm infants, implemented in the neonatal intensive care unit before the infant has reached 37 weeks of corrected gestational age, will be considered eligible. Primary outcome is parental sensitivity. Depending on the availability and quality of data, a meta-analysis will be done. Alternatively, a qualitative synthesis of data is planned. The systematic review follows the PRISMA recommendations. Finally, risk of bias and quality of the evidence of included studies will be assessed. DISCUSSION To our knowledge, this will be the first systematic review to examine the effect of early interventions that promote parental sensitivity of parents of preterm infants in the neonatal intensive care unit. The results of this review will guide development of best practice guidelines and recommendations for further research and will have implications for neonatal clinical practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016047083.
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Affiliation(s)
- Andréane Lavallée
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montreal, Qc, H3T 1A8, Canada.
| | - Marilyn Aita
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montreal, Qc, H3T 1A8, Canada.,Research Center of the CHU Sainte-Justine, Montreal, Canada
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, 2375 Chemin de la Côte-Sainte-Catherine, Montreal, Qc, H3T 1A8, Canada.,Research Center of the Institut universitaire de gériatrie de Montréal, Montreal, Canada
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Bélanger L, Bourbonnais A, Bernier R, Benoit M. Communication between nurses and family caregivers of hospitalised older persons: a literature review. J Clin Nurs 2016; 26:609-619. [PMID: 27539680 DOI: 10.1111/jocn.13516] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To review the literature concerning the feelings, thoughts and behaviours of nurses and family caregivers of hospitalised older persons when they communicate with one another. BACKGROUND Communication between nurses and family caregivers of hospitalised older persons is not always optimal. Improving the frequency and quality of this communication might be a way to make the most of available human capital in order to better care for hospitalised older people. DESIGN A literature review was carried out of qualitative, quantitative and mixed-design studies relating to communication between nurses and family caregivers. Findings were analysed thematically. RESULTS Family caregiver thoughts, feelings and behaviours relative to nurse control and authority, nurse recognition of their contribution, information received from and shared with nurses and care satisfaction could influence communication with nurses. Nurse thoughts regarding usefulness of family caregivers as care partners and their lack of availability to meet family caregiver demands could influence communication with family caregivers. CONCLUSIONS The thoughts, feelings and behaviours of family caregivers and nurses that might create positive or negative circular patterns of communication are evidenced. Further research is required to gain a more comprehensive understanding of the phenomenon. RELEVANCE TO CLINICAL PRACTICE Nurses must be trained in how to communicate with family caregivers in order to form a partnership geared to preventing complications in hospitalised older persons. Results could be used to inform policy regarding the care of hospitalised older persons.
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Affiliation(s)
| | - Anne Bourbonnais
- Faculté des sciences infirmières, Université de Montréal, Montréal, QC, Canada
| | | | - Monique Benoit
- Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
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Côté J, Rouleau G, Ramirez-Garcia P, Bourbonnais A. Virtual Nursing Intervention Adjunctive to Conventional Care: The Experience of Persons Living With HIV. JMIR Res Protoc 2015; 4:e124. [PMID: 26487327 PMCID: PMC4704901 DOI: 10.2196/resprot.4158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 07/21/2015] [Accepted: 09/20/2015] [Indexed: 11/16/2022] Open
Abstract
Background Persons living with HIV (PLHIV) must adhere optimally to antiretroviral therapy (ART) on a daily basis and for their lifetime to maintain an undetectable viral load, allowing them to preserve their health. Taking advantage of the opportunity that information and communication technologies provide to broaden intervention modalities and intensify clinical follow-up, a virtual nursing intervention consisting of four interactive computer sessions was developed to empower PLHIV to manage their ART and symptoms optimally. Compared with other types of information and communication technologies-assisted interventions such as text messages, HIV Treatment, Virtual Nursing Assistance and Education (VIH-TAVIE) requires a certain degree of active engagement on the part of the user to develop and strengthen the self-management skills to optimize adherence. After the intervention’s impact on ART adherence was measured quantitatively, a qualitative study was undertaken to describe how users experience the intervention. Understanding how PLHIV perceive being assisted asynchronously by a virtual nurse was of particular interest. Objective The objective of the study was to explore and describe how PLHIV experience VIH-TAVIE, that is, receiving customized asynchronous accompaniment via a virtual nurse. Methods A qualitative study was conducted with 26 PLHIV (20 men, 6 women) who received all four VIH-TAVIE sessions. Participants had been diagnosed with HIV 14 years earlier on average and had been on ART for a mean period of 10 years. The sessions lasted 20-30 minutes each and were received two weeks apart. They are hosted by a virtual nurse who engages the user in a self-management skills-learning process for the purpose of treatment adherence. Semistructured interviews were conducted lasting 30-40 minutes to get participants to share their experience of the intervention through personal stories and what they thought and felt during their participation. Data were analyzed using Miles and Huberman’s method, by performing these three steps: (1) data reduction (data coding, summaries); (2) data display (in tables and text form); and (3) recontextualization of results. Results Content analysis yielded five themes regarding how PLHIV experience VIH-TAVIE: (1) exposure to the virtual nursing intervention; (2) virtual nurse humanizes experience of the computer-delivered intervention; (3) learner’s experience of the virtual nursing intervention; (4) perceived benefits following participation in the virtual nursing intervention; and (5) relevance of the virtual nursing intervention in relation to the medication management trajectory. Conclusions Analyzing the participants’ experience revealed they found the intervention’s content and format appropriate. To them, the virtual nurse humanized the experience and helped them acquire new skills for achieving optimal ART adherence. Results seem to underscore the importance of offering the intervention to persons who have more problems with drug intake or who are just beginning ART.
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Affiliation(s)
- José Côté
- Research Centre of the Centre Hospitalier de l'Université de Montréal, Research Chair in Innovative Nursing Practices, Montréal, QC, Canada.
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Bourbonnais A. [Ethnography for nursing research, a sensible way to understand human behaviors in their context]. Rech Soins Infirm 2015:23-34. [PMID: 26510344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Understanding human behaviours is at the heart of the nursing discipline. Knowledge development about behaviours is essential to guide nursing practice in the clinical field, for nursing education or in nursing management. In this context, ethnography is often overlooked as a research method to understand better behaviours in their sociocultural environment This article aims to present the principles guiding this qualitative method and its application to nursing research. First, the ethnographic method and some of its variants will be described. The conduct of an ethnographic study will then be exposed. Finally, examples of ethnographic studies in nursing will be presented. This article provides a foundation for the development of research protocols using ethnography for the advancement of nursing knowledge, as well as better use of ethnographic findings to improve care practices.
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Côté J, Godin G, Ramirez-Garcia P, Rouleau G, Bourbonnais A, Guéhéneuc YG, Tremblay C, Otis J. Virtual intervention to support self-management of antiretroviral therapy among people living with HIV. J Med Internet Res 2015; 17:e6. [PMID: 25563775 PMCID: PMC4296100 DOI: 10.2196/jmir.3264] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 06/11/2014] [Accepted: 11/08/2014] [Indexed: 12/02/2022] Open
Abstract
Background Living with human immunodeficiency virus (HIV) necessitates long-term health care follow-up, particularly with respect to antiretroviral therapy (ART) management. Taking advantage of the enormous possibilities afforded by information and communication technologies (ICT), we developed a virtual nursing intervention (VIH-TAVIE) intended to empower HIV patients to manage their ART and their symptoms optimally. ICT interventions hold great promise across the entire continuum of HIV patient care but further research is needed to properly evaluate their effectiveness. Objective The objective of the study was to compare the effectiveness of two types of follow-up—traditional and virtual—in terms of promoting ART adherence among HIV patients. Methods A quasi-experimental study was conducted. Participants were 179 HIV patients on ART for at least 6 months, of which 99 were recruited at a site offering virtual follow-up and 80 at another site offering only traditional follow-up. The primary outcome was medication adherence and the secondary outcomes were the following cognitive and affective variables: self-efficacy, attitude toward medication intake, symptom-related discomfort, stress, and social support. These were evaluated by self-administered questionnaire at baseline (T0), and 3 (T3) and 6 months (T6) later. Results On average, participants had been living with HIV for 14 years and had been on ART for 11 years. The groups were highly heterogeneous, differing on a number of sociodemographic dimensions: education, income, marital status, employment status, and living arrangements. Adherence at baseline was high, reaching 80% (59/74) in the traditional follow-up group and 84% (81/97) in the virtual follow-up group. A generalized estimating equations (GEE) analysis was run, controlling for sociodemographic characteristics at baseline. A time effect was detected indicating that both groups improved in adherence over time but did not differ in this regard. Improvement at 6 months was significantly greater than at 3 months in both groups. Analysis of variance revealed no significant group-by-time interaction effect on any of the secondary outcomes. A time effect was observed for the two kinds of follow-ups; both groups improved on symptom-related discomfort and social support. Conclusions Results showed that both interventions improved adherence to ART. Thus, the two kinds of follow-up can be used to promote treatment adherence among HIV patients on ART.
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Affiliation(s)
- José Côté
- Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
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Bourbonnais A. L’ethnographie pour la recherche infirmière, une méthode judicieuse pour mieux comprendre les comportements humains dans leur contexte. Rech Soins Infirm 2015. [DOI: 10.3917/rsi.120.0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Mailhot T, Cossette S, Bourbonnais A, Côté J, Denault A, Côté MC, Lamarche Y, Guertin MC. Evaluation of a nurse mentoring intervention to family caregivers in the management of delirium after cardiac surgery (MENTOR_D): a study protocol for a randomized controlled pilot trial. Trials 2014; 15:306. [PMID: 25073881 PMCID: PMC4133622 DOI: 10.1186/1745-6215-15-306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the use of evidence-based preventive measures, delirium affects about 40% of patients following cardiac surgery with the potential for serious clinical complications and anxiety for caregivers. There is some evidence that family involvement as a core component of delirium management may be beneficial since familiarity helps patients stay in contact with reality, however, this merits further investigation. There is also currently a gap in the scientific literature regarding objective indicators that could enhance early detection and monitoring of delirium. Therefore, this randomized pilot trial examines the acceptability, feasibility, and preliminary efficacy of an experimental nursing intervention to help family caregivers manage post-cardiac surgery delirium in their relatives. It also explores the validity of a new and innovative measure that has potential as an indicator for delirium. METHODS/DESIGN In this two-group randomized pilot study (n = 30), the control group will receive usual care and the intervention group will receive the experimental intervention aimed at reducing delirium severity. The intervention nurse's objective will be to foster the family caregiver's self-efficacy in behaving in a supportive manner during delirium episodes. Data will be collected from standard delirium assessment scales and a novel measure of delirium, i.e., cerebral oximetry obtained using near infrared spectroscopy, as well as medical records and participants' responses to questionnaires. DISCUSSION New strategies for early detection, monitoring, and management of delirium are needed in order to improve outcomes for both patients and families. The present article exposes feasibility issues based on the first few months of the empirical phase of the study that may be useful to the scientific community interested in improving the care of patients with delirium. Another potentially important contribution is in the exploration of cerebral oximetry, a promising measure as an objective indicator for early detection and continuous monitoring of delirium. The proposed pilot study will build towards a larger trial with the potential to improve knowledge about delirium management and monitoring. TRIAL REGISTRATION This pilot study was registered at Controlled Trials on March 27th 2013 and was assigned #ISRCTN95736036.
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Affiliation(s)
- Tanya Mailhot
- Faculty of Nursing, University of Montreal, C,P, 6128 succ, Centre-ville, Montreal, Quebec H3C 3J7, Canada.
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Côté J, Bourbonnais A, Rouleau G, Ramirez-Garcìa P, Couture M, Massé B, Tremblay C. Psychosocial profile and lived experience of HIV-infected long-term nonprogressors: a mixed method study. J Assoc Nurses AIDS Care 2014; 26:164-75. [PMID: 24759059 DOI: 10.1016/j.jana.2014.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 02/22/2014] [Indexed: 10/25/2022]
Abstract
The goal of this mixed method study was to describe the psychosocial profile of HIV-infected persons identified as long-term nonprogressors (LTNP), and their experiences of nonprogression. Data were collected from 24 participants with a mean age of 48 years and a mean duration of infection of 14 years. Results show rather moderate levels of anxiety and depression symptoms and a modest mean score of social support. Participants adapted by using acceptance, positive restructuring, and active coping strategies. Seven themes marked the experience: (a) reacting to announcement and dealing with diagnosis, (b) valuing interpersonal relations and well-being, (c) making changes in life, (d) coping with stress, (e) dealing with health care, (f) beliefs about reasons for nonprogression, and (g) living positively while dreading progression. The findings enrich a field of knowledge that has had little attention so far and shed light on the psychosocial profile of LTNP and their experiences of nonprogression.
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Abstract
This article describes the social positioning of older people living with Alzheimer's disease who scream in a long-term care home. Few studies have focused on the social positions taken by older people, their family and formal caregivers during interaction and their effects on screams. A secondary data analysis was conducted using Harré and Van Langenhove's positioning theory. The results show that older people are capable of positioning and repositioning themselves in relational patterns. Family and formal caregivers position older people who scream according to their beliefs about their lived experience. They also react emotionally to older people and try to influence their behaviors. Understanding the social positioning of older people with Alzheimer's disease brought out their capacities and their caregivers' concerns for their well-being. Interventions should focus on these strengths and on promoting healthy relations in the triads to enhance quality of care in long-term care homes.
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Affiliation(s)
| | - Francine Ducharme
- Université de Montréal, Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
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Abstract
This article presents a critical review of empirical data to guide knowledge development of screaming in elderly persons with dementia. Many reasons have been identified for why humans and animals scream. Studies on elderly populations have focused mostly on factors associated with screaming. Also, a vast selection of interventions for elderly persons with dementia who scream has been tested, but there is little evidence of their efficacy. Better knowledge of screaming in this population is needed. In particular, the meaning of this behaviour must be determined and stronger evidence of the efficacy of interventions must be acquired. In order to develop helpful clinical interventions, it is suggested that diverse research methods be used and that the perspective of all actors involved be considered, including that of the elderly persons, their families and their professional caregivers.
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Brassard P, Frisch F, Lavoie F, Cyr D, Bourbonnais A, Cunnane SC, Patterson BW, Drouin R, Baillargeon JP, Carpentier AC. Impaired plasma nonesterified fatty acid tolerance is an early defect in the natural history of type 2 diabetes. J Clin Endocrinol Metab 2008; 93:837-44. [PMID: 18182453 PMCID: PMC2266943 DOI: 10.1210/jc.2007-1670] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Abnormal plasma nonesterified fatty acid (NEFA) metabolism may play a role in the development of type 2 diabetes. OBJECTIVES Our objectives were to demonstrate whether there is a defect in insulin-mediated suppression of plasma NEFA appearance (RaNEFA) and oxidation (OxNEFA) during enhanced intravascular triacylglycerol lipolysis early in the natural history of type 2 diabetes, and if so, to determine whether other mechanisms than reduced insulin-mediated suppression of intracellular lipolysis are involved. DESIGN These are cross-sectional studies. SETTING The studies were performed at an academic clinical research center. PARTICIPANTS Nine healthy subjects with both parents with type 2 diabetes (FH+) and nine healthy subjects with no first-degree relatives with type 2 diabetes (FH-) with similar anthropometric features were included in the studies. INTERVENTIONS Pancreatic clamps and iv infusion of stable isotopic tracers ([1,1,2,3,3-(2)H5]-glycerol and [U-(13)C]-palmitate or [1,2-(13)C]-acetate) were performed while intravascular triacylglycerol lipolysis was simultaneously clamped by iv infusion of heparin plus Intralipid at low (fasting) and high insulin levels. Oral nicotinic acid (NA) was used to inhibit intracellular lipolysis. MAIN OUTCOME MEASURES RaNEFA and OxNEFA were determined. RESULTS During heparin plus Intralipid infusion at high plasma insulin levels, and despite similar intravascular lipolytic rates, FH+ had higher RaNEFA and OxNEFA than FH- (RaNEFA: 17.4+/-6.3 vs. 9.2+/-4.2; OxNEFA: 4.5+/-1.8 vs. 2.3+/-1.5 micromol/kg lean body mass/min), independent of NA intake, gender, age, and body composition. In the presence of NA, insulin-mediated suppression of RaNEFA was still observed in FH-, but not in FH+. CONCLUSIONS Increased RaNEFA and OxNEFA during intravascular lipolysis at high insulin levels occur early in the natural history of type 2 diabetes.
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Affiliation(s)
- P Brassard
- Department of Medicine, Division of Endocrinology, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada J1H 5N4
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Francoeur L, Bourbonnais A. [The problems for the aged living at home]. Infirm Que 2002; 9:28, 40-4. [PMID: 11961949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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