Smoking and mental disability : A mixed observational study using a diverse sample of medical-social establishments and services

INTRODUCTION

A multi-center observational study was carried out in ten ESMS, using a mixed methodology (site visits, questionnaire survey, semi-directive group interviews with professionals and individual interviews with users).

PURPOSE OF THE RESEARCH

The aim of this article is to describe the management and prevention of smoking in ESMS for people with mental health disorders, and to characterize and identify the smoking behaviors and representations of ESMS users and the professionals working there.

RESULTS

The study made it possible to distinguish between ESMS in terms of the organization of smoking areas and tobacco prevention initiatives. It also revealed that 37 percent of respondents among the professionals said they smoked tobacco, with some of them explaining that they smoked with users and sometimes gave them cigarettes. With regard to prevention, there was a consensus among professionals that they should help users who wanted to stop smoking. Professionals were divided, however, on the need for more active prevention, citing the users’ freedom and the fact that ESMS are places where people live. Among the users, 47 percent said they were smokers. Of the users who smoked, 55 percent said they wanted to stop. Interviews with the users revealed that twelve of them wanted to quit, with some asking for help and more assistance from professionals.

CONCLUSIONS

This report suggests that intervention research could be developed in ESMS for people with mental health disorders, who could benefit from the smoking prevention actions identified in the facilities and services investigated.

Health professionals' perceptions of patient safety competencies: psychometric properties of the French version of the H-PEPSS in France and Switzerland

BACKGROUND

Several initiatives have been implemented to develop, manage, and assess patient safety (PS) competencies, which are considered as a serious public health issue across the world. The Health Professional Education in Patient Safety Survey (H-PEPSS) is widely used as a psychometric scale for evaluating perceived PS competencies but has not been validated in French. The purpose of the study was to investigate the main psychometric properties of the French version of the H-PEPSS.

METHODS

A total of 449 students enrolled in nursing and physiotherapy schools in France and French-speaking Switzerland completed a self-administered questionnaire. The 38 items of the H-PEPSS were translated into French following a committee approach. The scale's construct validity was assessed using confirmatory factor analysis. Reliability of the six factors of the H-PEPSS was evaluated using Cronbach α and McDonald's ω. Measurement invariance across countries and academic majors as well as discriminant validity were also investigated.

RESULTS

After we removed one item, the H-PEPSS 6-factor model demonstrated adequate goodness-of-fit statistics (χ2[194] = 316.633, χ2/df = 1.632, p < 0.001, CFI = 0.934, TLI = 0.922, RMSEA = 0.041 [0.033, 0.049], SRMR = 0.044). The total score can be also used as an overall measure of PS competence (χ2[203] = 342.251, χ2/df = 1.686, p < 0.001, CFI = 0.925, TLI = 0.915, RMSEA = 0.043 [0.035, 0.051], SRMR = 0.047). One item was removed because of its high multicollinearity with other items. The reliability was deemed satisfactory (Cronbach α ≥ 0.60), except for the "Understanding human and environmental factors" subscale. Consistently, this subscale was often reported with the lowest reliability in previous studies. We confirmed scalar invariance between countries and partial scalar invariance between majors (ΔCFI ≤ 0.01). The heterotrait-monotrait ratio of correlations ranged from 0.63 to 0.91. In our results, country, academic year, and academic satisfaction were frequently the main predictors of self-reported PS competencies.

CONCLUSION

Perceived PS competencies can be assessed and fairly compared across France and Switzerland and across nursing and physiotherapy students. We discuss the relevance of the introduction of the H-PEPSS in the training pathway of health professions degree courses and the fallout in clinical contexts.

Effect of an interprofessional simulation program on patient safety competencies of healthcare professionals in Switzerland: a before and after study

PURPOSE

This study aimed to identify the effects of a 12-week interprofessional simulation program, operated between February 2020 and January 2021, on the patient safety competencies of healthcare professionals in Switzerland.

METHODS

The simulation training was based on 2 scenarios of hospitalized patients with septic shock and respiratory failure, and trainees were expected to demonstrate patient safety competencies. A single-group before and after study was conducted after the intervention-simulation program, using a measurement tool (the Health Professional Education in Patient Safety Survey) to measure the perceived competencies of physicians, nurses, and nursing assistants. Out of 57 participants, 37 answered the questionnaire surveys 4 times: 48 hours before the training, followed by post-surveys at 24 hours, 6 weeks, and 12 weeks after the training. The linear mixed effect model was applied for the analysis.

RESULTS

Four components out of 6 perceived patient safety competencies improved at 6 weeks but returned to a similar level before training at 12 weeks. Competencies of "communicating effectively," "managing safety risks," "understanding human and environmental factors that influence patient safety," and "recognize and respond to remove immediate risks of harm" are statistically significant both overall and in the comparison between before the training and 6 weeks after the training.

CONCLUSION

Interprofessional simulation programs contributed to developing some areas of patient safety competencies of healthcare professionals, but only for a limited time. Interprofessional simulation programs should be repeated and combined with other forms of support, including case discussions and debriefings, to ensure lasting effects.

Disclosure of myelodysplastic syndrome diagnosis: improving patients' understanding and experience

PURPOSE

How a diagnosis of cancer is disclosed can affect psychological morbidity. Haematological malignancy specialised terminology may make the disclosure difficult. We analysed how disclosure of a diagnosis of myelodysplastic syndrome (MDS) is experienced by patients.

METHODS

Patients from the French MDS support group were questioned about their demographic and clinical characteristics, diagnosis disclosure circumstances as well as experiences and expectations. After a phase test, a written questionnaire was sent to the 150 members of the support group.

RESULTS

Of the 73 patients who returned a useable questionnaire, disclosure had been experienced negatively by 32 patients (45%). Only 53% of those patients were satisfied with the information provided compared with 80% of those who had positive/neutral feelings (P = 0.02). Overall, patients felt they should have been given fuller information at the time of disclosure. In retrospect, almost all patients (94%) thought that comprehensive, accurate information should be provided at disclosure, even if the truth might be hard to cope with. Patients reporting not having been given satisfactory information complained about a lack of perspective (3) or clarity (7), eight (11%) mentioned cancer during the interview, and four explicitly expressed that this word should be more frequently used.

CONCLUSION

Many patients had experienced disclosure negatively, frequently finding that the information provided had been insufficient and feeling that MDS was not well understood as a disease. Haematologists disclosing diagnosis to patients with a blood malignancy may benefit from following the same guidelines as oncologists in delivering comprehensive, understandable information.